[An out-patient clinic for filler complications]

The use of fillers for cosmetic improvement is increasing. As a result, the number of complications is rising too. Being confronted with facial nodules of unknown origin, many doctors who are not involved in cosmetic medicine are not inclined to consider filler complication as part of a differential diagnosis. Three illustrative cases are discussed; all attended a dedicated out-patient clinic at Erasmus MC for filler complications. Between 2011 and 2016, a total of 401 patients were referred. The majority (84.6%) presented with complications of permanent fillers being injected more than ten years earlier. For this group, the new intralesional laser therapy technique is a potential treatment option. This improves the medical problem, but not always the cosmetic element. Complications of hyaluronic acid fillers can usually be managed with hyaluronidase injections. A new and growing group of referrals to the clinic concerns patients with large amounts of permanents fillers in the buttocks.