Injectable fillers: an American perspective.

Area of Science:

• Dermatology
• Plastic Surgery
• Cosmetic Science

Background:

• The United States Food and Drug Administration (FDA) has approved a range of dermal fillers since 1981 for cosmetic and reconstructive purposes.
• Available fillers include collagen, hyaluronic acid, poly-L-lactic acid, calcium hydroxylapatite, and polymethylmethacrylate.
• Many fillers were introduced internationally before FDA approval, with complications documented globally.

Purpose of the Study:

• To review three specific injectable fillers that have been associated with significant complications.
• To discuss fillers available internationally or used off-label in the USA.
• To inform practitioners about potential risks associated with certain dermal filler products.

Main Methods:

• Literature review of available dermal fillers.
• Analysis of complication data from studies conducted in the USA and internationally.
• Focus on three specific fillers: liquid injectable silicone, DermaLive/DermaDeep, and Bio-Alcamid.

Main Results:

• Several dermal fillers, particularly those used internationally or off-label, have been linked to significant adverse events.
• The review specifically examines complications associated with liquid injectable silicone, DermaLive/DermaDeep, and Bio-Alcamid.
• Understanding these complications is crucial for patient safety and informed clinical decision-making.

Conclusions:

• Practitioners should be aware of the potential complications associated with various dermal fillers, especially those used off-label or with limited FDA data.
• A thorough understanding of filler properties and associated risks is essential for safe cosmetic and reconstructive procedures.
• Continued vigilance and reporting of adverse events are necessary to ensure patient safety in aesthetic medicine.