Summary of the 29 Cases of Early Complications Associated With Hyaluronic Acid Filler Injections (Patients Injected in 2021)
| Case no. . | Agea /sex . | Date of injection (2021) . | Date of onset (2021) . | Filler brand . | Injection site . | Injection type (Gauge) . | Complication . | Management . | Injector Proficiencyb . | Outcome . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 38F | 1/4 | 1/4 | Juvéderm Vista Volbella XC | Periorbital puffiness | Needle | Infection | − Antibiotics, drainage several times | 1 yr 9 mo MD, plastic surgeon | Resolved |
| 2 | 56F | 3/2 | 3/2 | Juvéderm Vista Ultra Plus XC | Forehead | Needle | Vascular compromise | − Hyaluronidase, prostaglandin + antibiotics | 2 yr 11 mo MD, dermatologist | Incomplete resolution |
| 3 | 47F | 3/7 | 3/10 | Juvéderm Vista Volux XC | Chin | Needle | Infection (possibility of injection into a vein) | − Hyaluronidase | 1 yr 2 mo MD, dermatologist | Resolved |
| 4 | 44F | 3/17 | 3/18 | Juvéderm Vista Voluma XC | Nasolabial fold | Needle | Vascular compromise (pain, numbness, epidermis peeling on nose tip and right wing of nose) | − Hyaluronidase, corticosteroid, antibiotics, prostaglandin + antibiotics, NSAIDs | 5 yr 5 mo MD, aesthetic surgeon | Resolved |
| 5 | 25F | 3/17 | 3/25 | Juvéderm Vista Volbella XC | Forehead | Cannula (18G) | Infection | − Hyaluronidase, antibiotics, antihistamine, synthetic antibacterial, H2-receptor antagonist | 0 yr 11 mo MD, plastic surgeon | Resolved |
| 6 | 37F | 4/14 | 4/15 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics + normal saline − antibiotics, prostaglandin | 2 yr 0 mo MD, aesthetic surgeon | Resolved |
| 7 | 28F | 4/21 | 4/21 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 2 yr 2 mo MD, PhD, plastic surgeon | Resolved |
| 8 | 37F | 4/24 | 4/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics, NSAIDs, prostaglandin | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 9 | 23F | 4/26 | 5/9 | Juvéderm Vista Volbella XC | Lips | Needle | Allergy | − Hyaluronidase | 2 yr 1 mo MD, dermatologist | Resolved |
| 10 | 54F | 5/6 | 5/6 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (23G) | Vascular compromise | − Hyaluronidase, prostaglandin | 7 yr 4 mo MD, aesthetic surgeon | Resolved |
| 11 | 62M | 5/31 | 5/31 | Juvéderm Vista Voluma XC + Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Hyaluronidase, prostaglandin, NSAIDs | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 12 | 36F | 6/19 | 6/19 | Juvéderm Vista Ultra Plus XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + normal saline − antibiotics + normal saline − hyaluronidase − prostaglandin, antibiotics, synthetic antibacterial, H2-receptor antagonist | 2 yr 2 mo MD, dermatologist | Resolved |
| 13 | 44F | 6/25 | 6/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Prostaglandin, antibiotics, NSAIDs − prostaglandin + petroleum jelly | 0 yr 2 mo MD, plastic surgeon | Resolved |
| 14 | 48F | 7/1 | 7/2 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − NSAIDs, antiplasmin, antibiotics, − hyaluronidase + normal saline | 2 yr 6 mo MD, aesthetic surgeon | Resolved |
| 15 | 33F | 7/13 | 7/13 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase − levofloxacin hydration, NSAIDs, corticosteroid, prostaglandin, antibiotics | 0 yr 10 mo MD, PhD, aesthetic surgeon | Resolved |
| 16 | 41F | 7/28 | 7/29 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (25G) | Vascular compromise | − Hyaluronidase, prostaglandin | 2 yr 3 mo MD, aesthetic surgeon | Resolved |
| 17 | 49F | 8/25 | 8/25 | Juvéderm Vista Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Clinic visit because of redness that did not disappear -> hyaluronidase on the right nasolabial fold | 0 yr 4 mo MD, plastic surgeon | Resolved |
| 18 | 31F | 9/19 | 9/23 | Juvéderm Vista Voluma XC + Volux XC | Midcheek groove | Cannula (25G) | Allergy | − Levofloxacin hydration, synthetic antibacterial | 1 yr 5 mo MD, dermatologist | Resolved |
| 19 | 55F | 10/11 | 10/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 1 yr 7 mo MD, dermatologist | Resolved |
| 20 | 31F | 10/13 | 10/13 | Juvéderm Vista Volbella XC | Periorbital puffiness and lips | Needle | Allergy | − Hyaluronidase, corticosteroid + normal saline, antihistamine, synthetic antibacterial | 1 yr 2 mo MD, dermatologist | Resolved |
| 21 | 45F | 10/17 | 10/18 | Juvéderm Vista Volbella XC + Juvéderm Vista Volift XC | Forehead | Needle | Neuropathy | − Vitamin B12 preparations | 2 yr 7 mo MD, dermatologist | Resolved |
| 22 | 40F | 10/18 | 10/18 | Juvéderm Vista Volbella XC | Upper eyelids | Needle | Acute conjunctivitis | − Caused by HA injection into the conjunctiva of the eyeball; − removal of HA at another ophthalmological center | 14 yr 6 mo MD, aesthetic surgeon | Lost to follow-up |
| 23 | 25M | 11/3 | 11/5 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase, antibiotics | 0 yr 7 mo MD, dermatologist | Resolved |
| 24 | 55F | 11/4 | 11/6 | Juvéderm Vista Voluma XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + antibiotics − prostaglandin, hyaluronidase, acetaminophen, levofloxacin hydration | 1 yr 2 mo MD, plastic surgeon | Resolved |
| 25 | 24F | 11/6 | 11/10 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase | 1 yr 7 mo MD, PhD, aesthetic surgeon | Resolved |
| 26 | 59F | 12/10 | 12/10 | Juvéderm Vista Volbella XC | Forehead | Cannula (25G) | Vascular compromise (Pulley vein layer extensive pain/poor circulation) | − Hyaluronidase | 2 yr 8 mo MD, aesthetic surgeon | Resolved |
| 27 | 51F | 12/9 | 12/9 | Juvéderm Vista Volift XC | Temple | Needle | Vascular compromise (redness along the right coronary artery) | − Hyaluronidase | 2 yr 6 mo MD, plastic surgeon | Resolved |
| 28 | 33F | 12/12 | 12/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, synthetic antibacterial, hydroquinone | 2 yr 9 mo MD, plastic surgeon | Resolved |
| 29 | 74F | 12/16 | 12/16 | Juvéderm Vista Volift XC | Forehead | Cannula | Neuropathy | − Vitamin B12 preparations, synthetic antibacterial | 0 yr 8 mo MD, aesthetic surgeon | Resolved |
| Case no. . | Agea /sex . | Date of injection (2021) . | Date of onset (2021) . | Filler brand . | Injection site . | Injection type (Gauge) . | Complication . | Management . | Injector Proficiencyb . | Outcome . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 38F | 1/4 | 1/4 | Juvéderm Vista Volbella XC | Periorbital puffiness | Needle | Infection | − Antibiotics, drainage several times | 1 yr 9 mo MD, plastic surgeon | Resolved |
| 2 | 56F | 3/2 | 3/2 | Juvéderm Vista Ultra Plus XC | Forehead | Needle | Vascular compromise | − Hyaluronidase, prostaglandin + antibiotics | 2 yr 11 mo MD, dermatologist | Incomplete resolution |
| 3 | 47F | 3/7 | 3/10 | Juvéderm Vista Volux XC | Chin | Needle | Infection (possibility of injection into a vein) | − Hyaluronidase | 1 yr 2 mo MD, dermatologist | Resolved |
| 4 | 44F | 3/17 | 3/18 | Juvéderm Vista Voluma XC | Nasolabial fold | Needle | Vascular compromise (pain, numbness, epidermis peeling on nose tip and right wing of nose) | − Hyaluronidase, corticosteroid, antibiotics, prostaglandin + antibiotics, NSAIDs | 5 yr 5 mo MD, aesthetic surgeon | Resolved |
| 5 | 25F | 3/17 | 3/25 | Juvéderm Vista Volbella XC | Forehead | Cannula (18G) | Infection | − Hyaluronidase, antibiotics, antihistamine, synthetic antibacterial, H2-receptor antagonist | 0 yr 11 mo MD, plastic surgeon | Resolved |
| 6 | 37F | 4/14 | 4/15 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics + normal saline − antibiotics, prostaglandin | 2 yr 0 mo MD, aesthetic surgeon | Resolved |
| 7 | 28F | 4/21 | 4/21 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 2 yr 2 mo MD, PhD, plastic surgeon | Resolved |
| 8 | 37F | 4/24 | 4/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics, NSAIDs, prostaglandin | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 9 | 23F | 4/26 | 5/9 | Juvéderm Vista Volbella XC | Lips | Needle | Allergy | − Hyaluronidase | 2 yr 1 mo MD, dermatologist | Resolved |
| 10 | 54F | 5/6 | 5/6 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (23G) | Vascular compromise | − Hyaluronidase, prostaglandin | 7 yr 4 mo MD, aesthetic surgeon | Resolved |
| 11 | 62M | 5/31 | 5/31 | Juvéderm Vista Voluma XC + Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Hyaluronidase, prostaglandin, NSAIDs | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 12 | 36F | 6/19 | 6/19 | Juvéderm Vista Ultra Plus XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + normal saline − antibiotics + normal saline − hyaluronidase − prostaglandin, antibiotics, synthetic antibacterial, H2-receptor antagonist | 2 yr 2 mo MD, dermatologist | Resolved |
| 13 | 44F | 6/25 | 6/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Prostaglandin, antibiotics, NSAIDs − prostaglandin + petroleum jelly | 0 yr 2 mo MD, plastic surgeon | Resolved |
| 14 | 48F | 7/1 | 7/2 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − NSAIDs, antiplasmin, antibiotics, − hyaluronidase + normal saline | 2 yr 6 mo MD, aesthetic surgeon | Resolved |
| 15 | 33F | 7/13 | 7/13 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase − levofloxacin hydration, NSAIDs, corticosteroid, prostaglandin, antibiotics | 0 yr 10 mo MD, PhD, aesthetic surgeon | Resolved |
| 16 | 41F | 7/28 | 7/29 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (25G) | Vascular compromise | − Hyaluronidase, prostaglandin | 2 yr 3 mo MD, aesthetic surgeon | Resolved |
| 17 | 49F | 8/25 | 8/25 | Juvéderm Vista Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Clinic visit because of redness that did not disappear -> hyaluronidase on the right nasolabial fold | 0 yr 4 mo MD, plastic surgeon | Resolved |
| 18 | 31F | 9/19 | 9/23 | Juvéderm Vista Voluma XC + Volux XC | Midcheek groove | Cannula (25G) | Allergy | − Levofloxacin hydration, synthetic antibacterial | 1 yr 5 mo MD, dermatologist | Resolved |
| 19 | 55F | 10/11 | 10/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 1 yr 7 mo MD, dermatologist | Resolved |
| 20 | 31F | 10/13 | 10/13 | Juvéderm Vista Volbella XC | Periorbital puffiness and lips | Needle | Allergy | − Hyaluronidase, corticosteroid + normal saline, antihistamine, synthetic antibacterial | 1 yr 2 mo MD, dermatologist | Resolved |
| 21 | 45F | 10/17 | 10/18 | Juvéderm Vista Volbella XC + Juvéderm Vista Volift XC | Forehead | Needle | Neuropathy | − Vitamin B12 preparations | 2 yr 7 mo MD, dermatologist | Resolved |
| 22 | 40F | 10/18 | 10/18 | Juvéderm Vista Volbella XC | Upper eyelids | Needle | Acute conjunctivitis | − Caused by HA injection into the conjunctiva of the eyeball; − removal of HA at another ophthalmological center | 14 yr 6 mo MD, aesthetic surgeon | Lost to follow-up |
| 23 | 25M | 11/3 | 11/5 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase, antibiotics | 0 yr 7 mo MD, dermatologist | Resolved |
| 24 | 55F | 11/4 | 11/6 | Juvéderm Vista Voluma XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + antibiotics − prostaglandin, hyaluronidase, acetaminophen, levofloxacin hydration | 1 yr 2 mo MD, plastic surgeon | Resolved |
| 25 | 24F | 11/6 | 11/10 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase | 1 yr 7 mo MD, PhD, aesthetic surgeon | Resolved |
| 26 | 59F | 12/10 | 12/10 | Juvéderm Vista Volbella XC | Forehead | Cannula (25G) | Vascular compromise (Pulley vein layer extensive pain/poor circulation) | − Hyaluronidase | 2 yr 8 mo MD, aesthetic surgeon | Resolved |
| 27 | 51F | 12/9 | 12/9 | Juvéderm Vista Volift XC | Temple | Needle | Vascular compromise (redness along the right coronary artery) | − Hyaluronidase | 2 yr 6 mo MD, plastic surgeon | Resolved |
| 28 | 33F | 12/12 | 12/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, synthetic antibacterial, hydroquinone | 2 yr 9 mo MD, plastic surgeon | Resolved |
| 29 | 74F | 12/16 | 12/16 | Juvéderm Vista Volift XC | Forehead | Cannula | Neuropathy | − Vitamin B12 preparations, synthetic antibacterial | 0 yr 8 mo MD, aesthetic surgeon | Resolved |
G, gauge; HA, hyaluronic acid. aAge of patients at the time of treatment. The average age was 42.24 ± 12.34 years (range: 23-74 years). bYear and month of injector’s experience at the time of injection. The average experience of injectors at the Shonan Beauty Clinic Medical Group was 28.69 ± 31.88 months (range: 2-174 months).
Summary of the 29 Cases of Early Complications Associated With Hyaluronic Acid Filler Injections (Patients Injected in 2021)
| Case no. . | Agea /sex . | Date of injection (2021) . | Date of onset (2021) . | Filler brand . | Injection site . | Injection type (Gauge) . | Complication . | Management . | Injector Proficiencyb . | Outcome . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 38F | 1/4 | 1/4 | Juvéderm Vista Volbella XC | Periorbital puffiness | Needle | Infection | − Antibiotics, drainage several times | 1 yr 9 mo MD, plastic surgeon | Resolved |
| 2 | 56F | 3/2 | 3/2 | Juvéderm Vista Ultra Plus XC | Forehead | Needle | Vascular compromise | − Hyaluronidase, prostaglandin + antibiotics | 2 yr 11 mo MD, dermatologist | Incomplete resolution |
| 3 | 47F | 3/7 | 3/10 | Juvéderm Vista Volux XC | Chin | Needle | Infection (possibility of injection into a vein) | − Hyaluronidase | 1 yr 2 mo MD, dermatologist | Resolved |
| 4 | 44F | 3/17 | 3/18 | Juvéderm Vista Voluma XC | Nasolabial fold | Needle | Vascular compromise (pain, numbness, epidermis peeling on nose tip and right wing of nose) | − Hyaluronidase, corticosteroid, antibiotics, prostaglandin + antibiotics, NSAIDs | 5 yr 5 mo MD, aesthetic surgeon | Resolved |
| 5 | 25F | 3/17 | 3/25 | Juvéderm Vista Volbella XC | Forehead | Cannula (18G) | Infection | − Hyaluronidase, antibiotics, antihistamine, synthetic antibacterial, H2-receptor antagonist | 0 yr 11 mo MD, plastic surgeon | Resolved |
| 6 | 37F | 4/14 | 4/15 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics + normal saline − antibiotics, prostaglandin | 2 yr 0 mo MD, aesthetic surgeon | Resolved |
| 7 | 28F | 4/21 | 4/21 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 2 yr 2 mo MD, PhD, plastic surgeon | Resolved |
| 8 | 37F | 4/24 | 4/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics, NSAIDs, prostaglandin | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 9 | 23F | 4/26 | 5/9 | Juvéderm Vista Volbella XC | Lips | Needle | Allergy | − Hyaluronidase | 2 yr 1 mo MD, dermatologist | Resolved |
| 10 | 54F | 5/6 | 5/6 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (23G) | Vascular compromise | − Hyaluronidase, prostaglandin | 7 yr 4 mo MD, aesthetic surgeon | Resolved |
| 11 | 62M | 5/31 | 5/31 | Juvéderm Vista Voluma XC + Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Hyaluronidase, prostaglandin, NSAIDs | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 12 | 36F | 6/19 | 6/19 | Juvéderm Vista Ultra Plus XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + normal saline − antibiotics + normal saline − hyaluronidase − prostaglandin, antibiotics, synthetic antibacterial, H2-receptor antagonist | 2 yr 2 mo MD, dermatologist | Resolved |
| 13 | 44F | 6/25 | 6/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Prostaglandin, antibiotics, NSAIDs − prostaglandin + petroleum jelly | 0 yr 2 mo MD, plastic surgeon | Resolved |
| 14 | 48F | 7/1 | 7/2 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − NSAIDs, antiplasmin, antibiotics, − hyaluronidase + normal saline | 2 yr 6 mo MD, aesthetic surgeon | Resolved |
| 15 | 33F | 7/13 | 7/13 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase − levofloxacin hydration, NSAIDs, corticosteroid, prostaglandin, antibiotics | 0 yr 10 mo MD, PhD, aesthetic surgeon | Resolved |
| 16 | 41F | 7/28 | 7/29 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (25G) | Vascular compromise | − Hyaluronidase, prostaglandin | 2 yr 3 mo MD, aesthetic surgeon | Resolved |
| 17 | 49F | 8/25 | 8/25 | Juvéderm Vista Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Clinic visit because of redness that did not disappear -> hyaluronidase on the right nasolabial fold | 0 yr 4 mo MD, plastic surgeon | Resolved |
| 18 | 31F | 9/19 | 9/23 | Juvéderm Vista Voluma XC + Volux XC | Midcheek groove | Cannula (25G) | Allergy | − Levofloxacin hydration, synthetic antibacterial | 1 yr 5 mo MD, dermatologist | Resolved |
| 19 | 55F | 10/11 | 10/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 1 yr 7 mo MD, dermatologist | Resolved |
| 20 | 31F | 10/13 | 10/13 | Juvéderm Vista Volbella XC | Periorbital puffiness and lips | Needle | Allergy | − Hyaluronidase, corticosteroid + normal saline, antihistamine, synthetic antibacterial | 1 yr 2 mo MD, dermatologist | Resolved |
| 21 | 45F | 10/17 | 10/18 | Juvéderm Vista Volbella XC + Juvéderm Vista Volift XC | Forehead | Needle | Neuropathy | − Vitamin B12 preparations | 2 yr 7 mo MD, dermatologist | Resolved |
| 22 | 40F | 10/18 | 10/18 | Juvéderm Vista Volbella XC | Upper eyelids | Needle | Acute conjunctivitis | − Caused by HA injection into the conjunctiva of the eyeball; − removal of HA at another ophthalmological center | 14 yr 6 mo MD, aesthetic surgeon | Lost to follow-up |
| 23 | 25M | 11/3 | 11/5 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase, antibiotics | 0 yr 7 mo MD, dermatologist | Resolved |
| 24 | 55F | 11/4 | 11/6 | Juvéderm Vista Voluma XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + antibiotics − prostaglandin, hyaluronidase, acetaminophen, levofloxacin hydration | 1 yr 2 mo MD, plastic surgeon | Resolved |
| 25 | 24F | 11/6 | 11/10 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase | 1 yr 7 mo MD, PhD, aesthetic surgeon | Resolved |
| 26 | 59F | 12/10 | 12/10 | Juvéderm Vista Volbella XC | Forehead | Cannula (25G) | Vascular compromise (Pulley vein layer extensive pain/poor circulation) | − Hyaluronidase | 2 yr 8 mo MD, aesthetic surgeon | Resolved |
| 27 | 51F | 12/9 | 12/9 | Juvéderm Vista Volift XC | Temple | Needle | Vascular compromise (redness along the right coronary artery) | − Hyaluronidase | 2 yr 6 mo MD, plastic surgeon | Resolved |
| 28 | 33F | 12/12 | 12/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, synthetic antibacterial, hydroquinone | 2 yr 9 mo MD, plastic surgeon | Resolved |
| 29 | 74F | 12/16 | 12/16 | Juvéderm Vista Volift XC | Forehead | Cannula | Neuropathy | − Vitamin B12 preparations, synthetic antibacterial | 0 yr 8 mo MD, aesthetic surgeon | Resolved |
| Case no. . | Agea /sex . | Date of injection (2021) . | Date of onset (2021) . | Filler brand . | Injection site . | Injection type (Gauge) . | Complication . | Management . | Injector Proficiencyb . | Outcome . |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 38F | 1/4 | 1/4 | Juvéderm Vista Volbella XC | Periorbital puffiness | Needle | Infection | − Antibiotics, drainage several times | 1 yr 9 mo MD, plastic surgeon | Resolved |
| 2 | 56F | 3/2 | 3/2 | Juvéderm Vista Ultra Plus XC | Forehead | Needle | Vascular compromise | − Hyaluronidase, prostaglandin + antibiotics | 2 yr 11 mo MD, dermatologist | Incomplete resolution |
| 3 | 47F | 3/7 | 3/10 | Juvéderm Vista Volux XC | Chin | Needle | Infection (possibility of injection into a vein) | − Hyaluronidase | 1 yr 2 mo MD, dermatologist | Resolved |
| 4 | 44F | 3/17 | 3/18 | Juvéderm Vista Voluma XC | Nasolabial fold | Needle | Vascular compromise (pain, numbness, epidermis peeling on nose tip and right wing of nose) | − Hyaluronidase, corticosteroid, antibiotics, prostaglandin + antibiotics, NSAIDs | 5 yr 5 mo MD, aesthetic surgeon | Resolved |
| 5 | 25F | 3/17 | 3/25 | Juvéderm Vista Volbella XC | Forehead | Cannula (18G) | Infection | − Hyaluronidase, antibiotics, antihistamine, synthetic antibacterial, H2-receptor antagonist | 0 yr 11 mo MD, plastic surgeon | Resolved |
| 6 | 37F | 4/14 | 4/15 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics + normal saline − antibiotics, prostaglandin | 2 yr 0 mo MD, aesthetic surgeon | Resolved |
| 7 | 28F | 4/21 | 4/21 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 2 yr 2 mo MD, PhD, plastic surgeon | Resolved |
| 8 | 37F | 4/24 | 4/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, antibiotics, NSAIDs, prostaglandin | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 9 | 23F | 4/26 | 5/9 | Juvéderm Vista Volbella XC | Lips | Needle | Allergy | − Hyaluronidase | 2 yr 1 mo MD, dermatologist | Resolved |
| 10 | 54F | 5/6 | 5/6 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (23G) | Vascular compromise | − Hyaluronidase, prostaglandin | 7 yr 4 mo MD, aesthetic surgeon | Resolved |
| 11 | 62M | 5/31 | 5/31 | Juvéderm Vista Voluma XC + Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Hyaluronidase, prostaglandin, NSAIDs | 1 yr 1 mo MD, aesthetic surgeon | Resolved |
| 12 | 36F | 6/19 | 6/19 | Juvéderm Vista Ultra Plus XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + normal saline − antibiotics + normal saline − hyaluronidase − prostaglandin, antibiotics, synthetic antibacterial, H2-receptor antagonist | 2 yr 2 mo MD, dermatologist | Resolved |
| 13 | 44F | 6/25 | 6/25 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Prostaglandin, antibiotics, NSAIDs − prostaglandin + petroleum jelly | 0 yr 2 mo MD, plastic surgeon | Resolved |
| 14 | 48F | 7/1 | 7/2 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − NSAIDs, antiplasmin, antibiotics, − hyaluronidase + normal saline | 2 yr 6 mo MD, aesthetic surgeon | Resolved |
| 15 | 33F | 7/13 | 7/13 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase − levofloxacin hydration, NSAIDs, corticosteroid, prostaglandin, antibiotics | 0 yr 10 mo MD, PhD, aesthetic surgeon | Resolved |
| 16 | 41F | 7/28 | 7/29 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Cannula (25G) | Vascular compromise | − Hyaluronidase, prostaglandin | 2 yr 3 mo MD, aesthetic surgeon | Resolved |
| 17 | 49F | 8/25 | 8/25 | Juvéderm Vista Volift XC | Nasolabial fold | Cannula (27G) | Vascular compromise | − Clinic visit because of redness that did not disappear -> hyaluronidase on the right nasolabial fold | 0 yr 4 mo MD, plastic surgeon | Resolved |
| 18 | 31F | 9/19 | 9/23 | Juvéderm Vista Voluma XC + Volux XC | Midcheek groove | Cannula (25G) | Allergy | − Levofloxacin hydration, synthetic antibacterial | 1 yr 5 mo MD, dermatologist | Resolved |
| 19 | 55F | 10/11 | 10/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase | 1 yr 7 mo MD, dermatologist | Resolved |
| 20 | 31F | 10/13 | 10/13 | Juvéderm Vista Volbella XC | Periorbital puffiness and lips | Needle | Allergy | − Hyaluronidase, corticosteroid + normal saline, antihistamine, synthetic antibacterial | 1 yr 2 mo MD, dermatologist | Resolved |
| 21 | 45F | 10/17 | 10/18 | Juvéderm Vista Volbella XC + Juvéderm Vista Volift XC | Forehead | Needle | Neuropathy | − Vitamin B12 preparations | 2 yr 7 mo MD, dermatologist | Resolved |
| 22 | 40F | 10/18 | 10/18 | Juvéderm Vista Volbella XC | Upper eyelids | Needle | Acute conjunctivitis | − Caused by HA injection into the conjunctiva of the eyeball; − removal of HA at another ophthalmological center | 14 yr 6 mo MD, aesthetic surgeon | Lost to follow-up |
| 23 | 25M | 11/3 | 11/5 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase, antibiotics | 0 yr 7 mo MD, dermatologist | Resolved |
| 24 | 55F | 11/4 | 11/6 | Juvéderm Vista Voluma XC | Midcheek groove | Needle | Vascular compromise | − Corticosteroid + antibiotics − prostaglandin, hyaluronidase, acetaminophen, levofloxacin hydration | 1 yr 2 mo MD, plastic surgeon | Resolved |
| 25 | 24F | 11/6 | 11/10 | Juvéderm Vista Volbella XC | Lips | Needle | Infection | − Hyaluronidase | 1 yr 7 mo MD, PhD, aesthetic surgeon | Resolved |
| 26 | 59F | 12/10 | 12/10 | Juvéderm Vista Volbella XC | Forehead | Cannula (25G) | Vascular compromise (Pulley vein layer extensive pain/poor circulation) | − Hyaluronidase | 2 yr 8 mo MD, aesthetic surgeon | Resolved |
| 27 | 51F | 12/9 | 12/9 | Juvéderm Vista Volift XC | Temple | Needle | Vascular compromise (redness along the right coronary artery) | − Hyaluronidase | 2 yr 6 mo MD, plastic surgeon | Resolved |
| 28 | 33F | 12/12 | 12/12 | Juvéderm Vista Ultra Plus XC | Nasolabial fold | Needle | Vascular compromise | − Hyaluronidase, synthetic antibacterial, hydroquinone | 2 yr 9 mo MD, plastic surgeon | Resolved |
| 29 | 74F | 12/16 | 12/16 | Juvéderm Vista Volift XC | Forehead | Cannula | Neuropathy | − Vitamin B12 preparations, synthetic antibacterial | 0 yr 8 mo MD, aesthetic surgeon | Resolved |
G, gauge; HA, hyaluronic acid. aAge of patients at the time of treatment. The average age was 42.24 ± 12.34 years (range: 23-74 years). bYear and month of injector’s experience at the time of injection. The average experience of injectors at the Shonan Beauty Clinic Medical Group was 28.69 ± 31.88 months (range: 2-174 months).
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