An Expensive Filler: Where Was Dermatology?

September 2014 | Volume 13 | Issue 9 | Editorials | 1013 | Copyright © September 2014

Jesse D. Jensen DO and Wendy McFalda DO

McLaren Oakland Medical Center, Pontiac, MI

a risk when injecting near the glabella, nasal bridge, alar groove, and infraorbital area. Ischemic complications may result as exterior pressure is exerted on the arterial lumen or by means of intraarterial blockage itself. Secondary embolization to the ophthalmic vessels will produce visual sequelae. Efficacy and safety are improved by utilization of cannulas.

Conclusion

The utilization of healthcare dollars for this case was immense, and the investigation regarding her filler procedure was nil. Early diagnosis and treatment could have been instituted by emergent consultation with dermatology. Appropriate intervention could have been implemented. With healthcare dollars under public scrutiny, it’s important that we educate our non-dermatologist colleagues regarding our specialty to prevent unnecessary or inappropriate diagnostic and therapeutic procedures.

Disclosure

The authors have not disclosed any relevant conflict of interest.

References

  1. Lowe, NJ et al. Adverse Reactions to Dermal Fillers: Review. Dermatol Surg 2005; 31:1616-1625.
  2. Park SW et al. Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. American Journal of Ophthalmology. 2012;154(4):653-662.
  3. Schanz S, SchippertW, Ulmer A, Rassner G, Fierlbeck G. Arterial embolization caused by injection of hyaluronic acid (Restylane). Br J Dermatol. 2002;146(5):928-929.
  4. Peter S, Mennel S. Retinal branch artery occlusion following injection of hyaluronic acid (Restylane). Clin Experiment Ophthalmol. 2006;34(4):363-364.
  5. Kim YJ, Kim SS, Song WK, Lee SY, Yoon JS. Ocular ischemia with hypotony after injection of hyaluronic acid gel. Ophthal Plast Reconstr Surg. 2011;27(6):e152-e155.
  6. Olenius M. The first clinical study using a new biodegradable implant for the treatment of lips, wrinkles, and folds. Aesthetic Plast Surg. 1998;22(2):97-101.

AUTHOR CORRESPONDENCE

Jesse D. Jensen DOjessdjensen@gmail.com