Unlike with the quilt (see Trapunto quilting) where you are taking the surface from flat to puffed, when dealing with the aging face the goal is to "fill" in a fold or crease that has lost volume to get it to a more "flat" surface. Soft tissue augmentation has become a popular means of addressing contour defects that result from aging, trauma and/or scarification (ie acne), or disease (ie HIV associated lipoatrophy).
Most are associated with minor adverse effects. Rarely more serious adverse effects will occur. These serious complications include the following:
- Rarely, death (eg, secondary to anaphylactic shock or sepsis)
- Anaphylactic reactions
- Blindness secondary to thrombus formation in the retinal artery after arterial injection periorbitally or from needle trauma: The use of higher viscosity materials (eg, Zyplast, Cymetra) should be avoided near the eyes or in the glabellar region. The needle should always be directed away from the eye.
- Local skin necrosis secondary to occlusion of cutaneous arterioles. This complication can be recognized early as vasoconstriction (blanching) and pain at the injection site. Immediate administration of heat, massage, and nitroglycerin paste can help to minimize or reverse permanent injury.
- Cystic reactions to implanted material or foreign body abscesses. These reactions are usually treated with incision and drainage and intralesional steroids.
- Cosmetic Interventions for HIV-Associated Lipoatrophy by Graeme J. Moyle, MD, MBBS -- MedScape Article
- Dermal Fillers by Roberta D Sengelmann, MD --eMedicine Article
- The Aging Face: More Than Skin Deep by Tina Alster, MD & others--MedScape Article
- Semipermanent and Permanent Dermal/Subdermal Fillers; Supplement to Plastic and Reconstructive Surgery, Vol 118, No 35, Sept 1, 2006