Risk of postinflammatory hyperpigmentation with Fern pattern technique in injecting hyaluronic acid gel

Fern pattern technique refers to a novel technique to inject acids gels in the dermis for optimal correction of dynamic facial lines. Although it has been proposed to show good results in correcting dynamic facial lines, it may result in higher risk of postinflammatory hyperpigmentation (PIH) since this technique requires multiple needle puncture for injection. We present a patient who showed PIH after injection of hyaluronic acid gel with this technique which made the facial lines more visibly apparent.