[Complication management after hyaluronic acid filler injections : VIO classification of adverse effects]

Hyaluronic acid fillers are among the most frequently used materials in aesthetic medicine. Despite their overall high safety profile, adverse events have been described, ranging from mild, self-limiting reactions to severe complications. The aim of this review is to present a structured and practice-oriented approach to the management of complications following hyaluronic acid filler injections. Based on international guidelines, the VIO (vascular, immunological, other) classification, and the recommendations of the International Society of Aesthetic Competence (ISAC), the pathophysiology, clinical presentation, and therapeutic strategies are summarized. The VIO classification allows for a clear categorization of adverse events and facilitates targeted treatment. In combination with the ISAC I-Secure algorithm, both acute and delayed complications can be managed effectively. A standardized approach improves patient safety and supports physicians in daily clinical practice.