21^st World Dermatology and Aesthetic Congress

Biography

Biography: Ramamurthy Subramaniam

Abstract

Facial fillers are becoming increasingly popular aesthetic procedures to temporarily reduce facial lines and folds, augment facial features or volumize facial compartments. However, even in the hands of very experienced injectors, there is always the possibility of dangerous complications like vascular injury, vascular occlusion by surrounding filler substance and intravascular injection of filler substance, which may lead to necrosis, blindness or even death. A prudent practitioner should be aware of the steps to minimize the risk of vascular complications, be able to identify the features of such complications promptly and to take the necessary steps to address those complications. It is useful if practitioners can group the steps to minimize the risk as patient factors, product factors and procedure factors. It is also prudent for the injecting physician to understand not only the facial anatomy but also the anatomy of an aging face as well. A detailed cosmetic or surgical history or history of trauma to the injecting site, as well as knowledge of the different concentrations, viscosity, G-prime and indication of the chosen filler is equally important. Though there are so-called claimed danger zones which are more dangerous than other areas, it is safer to adapt a “There is no safe zone” approach. Early detection and interference in the progression of a comprised vessel cannot be underestimated. Several journals claim that early intervention may reverse the complication and prevent necrosis or even blindness. Treatment modality differs for necrosis resulting from obstruction by surrounding fillers and necrosis due to intravascular cannulation. Thus the treatment options and drugs should base on the causative factor. Having an emergency “Filler Rescue Kit” is as important as having the contact details of a plastic surgeon, ophthalmologist and neurologist for referral.