Complications of fillers: Overview

BACKGROUND. Avoiding complications requires thorough training and medical, anatomic, and esthetic common sense. Complications can occur as a function of anatomic location, technique deficiencies, the type of defect treated, identifiable host factors, infectious processes, and allergies as a consequence of intrinsic characteristics of any particular filler. They can also occur in the absence of any identifiable host factors and flawless technique. Complications following temporary fillers often occur soon after augmentation, may resolve spontaneously, and are usually easy to treat. Conversely, complications that occur after using permanent or semipermanent fillers can appear months to years after augmentation and prove very difficult to treat. OBJECTIVE. To analyze and describe complications that have occurred following soft tissue augmentation and to present strategies for avoiding, recognizing, and treating them. METHODS. Protocols and observations derived from a 24-year experience using a wide variety of soft tissue augmenting agents are presented in association with pertinent clinical literature. Characteristic complications associated with specific types of soft tissue augmenting agents are presented in tabular form. CONCLUSION. Tissue fillers offer patients an opportunity for instant gratification with minimum downtime and, in general, an extremely favorable risk-to-benefit ratio. The best way to minimize complications in both your patients and yourself is to avoid them.