Complications of Dermal Injectables-A Retrospective Study
Lynhda Nguyen1,2, Stefan W Schneider2, Ute Siemann-Harms2
1Department of Laser and Aesthetics, Department of Dermatology and Venereology, University Medical-Center Hamburg-Eppendorf, Hamburg, Germany.
Journal of Cosmetic Dermatology
|January 20, 2026
Summary
Hyaluronic acid (HA) injectables can cause complications like biofilm and immune reactions, especially when administered by unqualified individuals using uncertified products. Patient safety requires qualified practitioners and strict product selection.
Area of Science:
- Dermatology
- Aesthetic Medicine
- Medical Device Safety
Background:
- Hyaluronic acid (HA) injectables are widely used for soft-tissue augmentation.
- While generally safe, HA fillers can lead to various short- and long-term complications.
Purpose of the Study:
- To investigate complications associated with hyaluronic acid (HA)-based soft-tissue augmentation.
- To analyze adverse events, their management, and outcomes in patients treated at a university hospital dermatology department.
Main Methods:
- Retrospective analysis of electronic medical records from January 2019 to January 2025.
- Identification and evaluation of adverse events linked to HA-based injectables, including management and outcomes.
Main Results:
- Thirty-one patients (mean age 50.4 years) experienced complications.
- Common issues included biofilm formation, chronic immune reactions, abscesses, Tyndall effect, vascular occlusion, and filler migration.
- A significant proportion of injections were performed by individuals with questionable qualifications, and over half of the products were uncertified or of unknown origin.
Conclusions:
- The study underscores the critical need for qualified practitioners and careful selection of HA filler products.
- Adherence to standardized injection techniques and robust regulatory oversight are essential for patient safety.
- Enhanced practitioner education and evidence-based protocols are recommended to mitigate risks in aesthetic procedures.
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