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Dermal Fillers in Aesthetics: An Overview of Adverse Events and Treatment Approaches

Funt, David1; Pavicic, Tatjana2

doi: 10.1097/PSN.0000000000000087
Articles: Review

Background: The ever-expanding range of dermal filler products for aesthetic soft tissue augmentation is of benefit for patients and physicians, but as indications and the number of procedures performed increase, the number of complications will likely also increase.

Objective: To describe potential adverse events associated with dermal fillers and to provide structured and clear guidance on their treatment and avoidance.

Methods: Reports of dermal filler complications in the medical literature were reviewed and, based on the publications retrieved and the authors' extensive experience, recommendations for avoiding and managing complications are provided.

Results: Different dermal fillers have widely varying properties, associated risks, and injection requirements. All dermal fillers have the potential to cause complications. Most are related to volume and technique, though some are associated with the material itself. The majority of adverse reactions are mild and transient, such as bruising and trauma-related edema. Serious adverse events are rare, and most are avoidable with proper planning and technique.

Conclusion: For optimum outcomes, aesthetic physicians should have a detailed understanding of facial anatomy; the individual characteristics of available fillers; their indications, contraindications, benefits, and drawbacks; and ways to prevent and avoid potential complications.

1Mount Sinai Hospital, Department of Plastic Surgery, New York, NY, USA

2Department of Dermatology and Allergy, Ludwig-Maximilian University, of Munich, Munich, Germany

Correspondence: Tatjana Pavicic, Department of Dermatology and Allergology, Ludwig Maximilian University of Munich, Frauenlobstrasse 9-11, 80337 Munich, Germany Tel +49 89 5160 6010 Email

David Funt, 19 Irving Place, Woodmere, New York, NY 11598, USA Tel +1 516 295 0404 Email

Reprinted with permission from Clinical, Cosmetic and Investigational Dermatology, 2013, vol. 6, pages 295–316.

© 2013 Funt and Pavicic. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:

Copyright © 2015 by American Society of Plastic Surgical Nurses