FILLERS INDUCED COMPLICATIONS OF THE LIPS: 10 YEARS EXPERIENCE WITH INTRALESIONAL LASER TREATMENT AND REFINEMENTS

ABSTRACT BACKGROUND: The number of minimally invasive cosmetic procedures have steadily increased every year. In the last decade the rates of filler injection reactions have also increased. This study presents our experience in the management and treatment of permanent filler complications to the lips. Undoubtedly, in these adverse reactions, the lips are the hallmark that most stigmatizes an unnatural look of the face. METHODS: 181 patients (168 female -13 male) with permanent filler complications to the lips were treated from September of 2009 to September of 2019, at the University Hospital of Modena. 135 patients underwent intralesional laser treatment (ILT). 46 patients underwent a stab incision and drainage, 10 of these patients had solid and calcified nodules and therefore underwent a combined technique. 33 patients underwent further cosmetic procedures. RESULTS: In 95 percent of patients there was a clinical improvement, of which complete resolution in 38,7 % and partial improvement in 34,2% of cases. Nine patients stopped the treatment because they were not satisfied. No patient was considered to have worsened after the treatment. Thirty-three patients underwent further treatments. CONCLUSIONS: Systematic combined approach between antibiotic therapy and treatments (ILT and a stab incision) represents the best therapeutic approach in dealing with permanent fillers complications to the lips. This treatment modality allows both the removal of the foreign material and the inflammatory reaction, with low morbidity and little cosmetic disfigurement. Further cosmetic procedures may be applied to improve aesthetic appearance once most of the nonresorbable substance has been removed.