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Intralesional laser successfully treats permanent facial filler complications

Treating inflammatory complications caused by permanent facial fillers with a minimally invasive laser technique has a high success rate, according to study results published in Plastic and Reconstructive Surgery.

The study included 219 patients treated between September 2006 and June 2013 for inflammatory nodules that developed as a result of permanent facial fillers. Mean age of the patients was 49 years (range, 23-72).

The researchers used an 808-nm diode laser (LASEmaR 800, Eufoton, Trieste, Italy), which was preferred as it resulted in less pain than other higher wavelengths.

In cases where the distribution in the tissue was “infiltrating,” as in a crisscross retrograde injection, the intralesional laser treatment was solely used. In cases where the distribution was “cystic,” as in bolus injections, draining through stab wound incisions was also used.

“Implant density is of utmost importance for the choice of the right extraction technique,” the researchers wrote. “Although recently injected gels maintain their structure and rheologic properties and are easily squeezed out, older implants can be extruded only through a 3-mm stab-wound incision after their density is reduced by an increase in temperature provided by the intralesional laser treatment.”

This treatment resulted in an overall improvement rate of 92% for the patients. Complete disappearance of lesions occurred in 62% of the patients, while partial improvement of a greater than 50% reduction was obtained in 30% of the patients. Treatment was discontinued by 8% due to a lack of satisfaction with results.

Complications included transient swelling in 100% of patients, smallpox-like scarring (n = 22), secondary sterile abscess (n = 21) and hematoma (n = 5).

“Although the learning curve for this type of intralesional treatment is not negligible, we believe this might be a breakthrough for this difficult group of patients,” the researchers concluded. – by Talitha Bennett

Disclosure: The researchers report no relevant financial disclosures.