ABSTRACT
A multitude of soft tissue fillers are currently available for facial aesthetic indications, ranging from autologous fat, polymethylmethacrylate, calcium hydroxyapatite, poly-L-lactic acid, polycaprolactone, and hyaluronic acid (HA). Because HA fillers have the powerful advantage of being completely removable using hyaluronidase, they are referred to as reversible and are currently the most widely used dermal fillers. HA fillers currently constitute the second most performed aesthetic modality after botulinum toxin. Vascular complications occur because of accidental direct injection of the filler into a vessel resulting in embolization in the surrounding areas, but also in distant locations. Delayed inflammatory reactions secondary to tissue filler administration develop after at least 2–4 weeks or later following an HA injection. The clinical manifestations occur in the form of recurrent episodes of localized solid edema with erythema and tenderness or as subcutaneous nodules at the site of HA injection.
