Managing Complications in Facial Cosmetic Treatment

To investigate the clinical and pathologic characteristics of adverse reactions after minimally invasive facial cosmetic treatment and to summarize diagnostic and therapeutic experiences, providing reference for clinicians.

Forty-five patients who experienced complications from minimally invasive facial cosmetic procedures and were treated at School and Hospital of Stomatology, Wuhan University between June 2014 and June 2024 were selected. A retrospective analysis was conducted on the diagnosis, treatment methods, and prognostic outcomes of these adverse reactions.

The average age of patients is 41 years (26-63 y), including 44 females and 1 male. Injection/filler materials were recorded for 28 patients: 46.4% (n=13) received autologous fat, 17.9% (n=5) botulinum toxin, 17.9% (n=5) hyaluronic acid, 7.1% (n=2) thread lifting, and 3.6% (n=1 each) received combinations of botulinum toxin and hyaluronic acid, silicone prothesis implants, or polyacrylamide hydrogel. Clinically, 97.8% (n=44) experienced local swelling, predominantly in the cheek (73.3%, n=33). Ultrasound showed low-density echoes in 77.8% (n=7) and non-contrast CT scans revealed soft tissue density masses in 66.7% (n=10). Twelve patients underwent surgical excision after conservative treatment failed. Pathologic findings included foreign body granulomas in 63.6% (n=7), lipogranuloma in 9.1% (n=1), chronic nonspecific inflammation in 18.2% (n=2), and epithelial dysplasia in 9.1% (n=1). All 12 surgical patients and the 33 non-surgical patients had favorable outcomes.

Adverse reactions to minimally invasive facial cosmetic procedures mainly occur in the cheeks of middle-aged women, often pathologically diagnosed as foreign body granuloma. Conservative treatment is the primary approach, but surgical excision is effective for unresponsive cases.