Injections with hyaluronic acid have become very common in recent years. In addition to corrections to the temples, cheeks, cheekbones or chin, “spraying the lips with hyaluronic acid” has become a very common treatment. Injections with hyaluronic acid are usually uncomplicated, but in rare cases problems can arise. A distinction is made between short-term and long-term problems after hyaluronic acid injections:

SHORT-TERM PROBLEMS after HYALURON injections – these occur a few hours after the injection

• Bruising – hematoma
• Swelling
• Pain
• Dislocation – Filler has “slipped”
• Vascular occlusion

LONG-TERM PROBLEMS after HYALURON injections – these occur weeks to years after the injection.

• Swelling and knot formation
• Granulomas
• Dislocation – Filler has “slipped”

Short-term problem – bruising

Bruising and bruising after injections cannot be ruled out 100%. It is important that the patient has not taken any blood-thinning medication. In addition to the long-term medication necessary to thin the blood, medication containing acetylsalicylic acid should be avoided at least 10 days before treatment.

Most bruises and hematomas are caused by treatment with needles. For this reason, we have been using techniques with blunt needles – so-called cannulas – for many years. As a result, bruises can be avoided better and downtimes can usually no longer be expected after a filler treatment.

If there is a bruise after all, creams containing heparin can help.

Short-term problem – swelling and pain

Both swelling and pain are closely related to bleeding under the skin. If these are prevented, swelling and pain after hyaluronic treatments are also rare. High-quality products also no longer have the typical behavior of storing water in the body, which means that swellings can also be expected. Modern hyaluronic acid products from well-known manufacturers also contain a lidocaine powder, which means that the treatment can often be almost painless.

Short-term problem – dislocation – the filler has “slipped”

If hyaluronic acid is injected into the mucous membrane instead of into the lip body, this can lead to lumps, lumps, bumps and, above all, pain. There is also the possibility that the result of a previous treatment may not correspond to the patient’s request. With a substance called hylase, it is possible to dissolve the gel – if it is hyaluronic acid – regardless of the manufacturer.

Short-term problem – vascular occlusion

This complication requires a professional approach by a competent doctor or by a specialist department of a clinic. The signs of vascular occlusion can often be mistaken for bruising. The area of the skin looks marbled and there is often pain in the affected area.

In the worst case, the filler that was injected into the vessel can also migrate to the vessel that supplies the retina. Unfortunately, there are more and more cases of blindness after filler injections. This serious complication has to be treated in a specialist ophthalmology department, since in addition to blood-thinning medication, especially hylase must be injected behind the eyeball.

As a doctor, I have to fear my complications for my patients every day? The answer is “no”. With careful handling of the products, knowledge of the anatomy and a lot of experience, this complication is very, very rare.

Long-term problem – swelling and knot formation

Have you had filler treatment a few weeks and months ago and are new swellings and lumps forming?

If everything was fine initially after the treatment and suddenly new swellings and lumps appear, this can be a delayed T-cell reaction. This is an immune response that is often caused by banal infections from other viruses such as. Flu viruses can be triggered. Some fillers are more prone to these reactions.

The first measure in this case is less hylase, but rather a combination treatment of cortisone and an antihistamine.

Langfristiges Problem – Granulome

Granulome sind schmerzhafte Knoten nach Fillerbehandlungen sie an Größe zunehmen und sich verändern. Diese seltenen Komplikationen sind mit modernen Fillern Gott sei Dank selten geworden. Sollte es sich um ein Granulom handeln, ist oft nur die chirurgische Entfernung die Lösung für das Problem

Long-term problem – dislocation – the filler has “slipped”

One of the reasons why the Austrian Society for Plastic, Reconstructive and Aesthetic Surgery fought many years ago for a ban on permanent fillers is that they mostly cause problems through “dislocation”. A filler that has been sprayed in the right place today can also be in the wrong place in 5 years if the technology is correct. The aging process changes the volume and consistency of the tissue. As a result, permanent fillers can no longer be in the right place and you have the feeling that the filler has slipped.