A Clinical and Economic Framework for Identifying Potentially Avoidable Infection-Related Costs Following Minimally...

Minimally invasive aesthetic procedures have steadily increased because of their accessibility, rapid recovery, and perceived low risk. However, disruption of the skin barrier, implantation of materials, manipulation of injectable products, and variability in biosafety practices may favor uncommon but clinically relevant infectious complications. This technical report proposes a clinical-economic framework to identify the clinical burden, health care resource use, and potentially avoidable costs associated with infections following procedures such as dermal fillers, botulinum toxin, mesotherapy, thread lifts, and other facial or body aesthetic interventions. The framework integrates clinical pathways in which infections may present as cellulitis, abscesses, persistent inflammatory nodules, granulomas, biofilm-associated complications, or delayed infections caused by rapidly growing nontuberculous mycobacteria, particularly Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum. These complications may lead to diagnostic delay, repeated empirical antibiotic use, special cultures, biopsy, imaging, drainage, debridement, material removal, combined antimicrobial therapy, and prolonged specialist follow-up. Their impact extends beyond the initial infectious event and may include aesthetic sequelae, psychological morbidity, loss of continuity of care, and substantial health care resource consumption. Potentially avoidable costs are concentrated in preventable process failures, including inadequate patient selection, deficient antisepsis, improper supply handling, products without traceability, absence of infection prevention protocols, low suspicion of mycobacterial infection, and delayed specialist referral. Infection prevention, product traceability, patient education, timely microbiological diagnosis, and standardized clinical pathways are essential components for reducing the clinical and economic burden of these complications.