BACKGROUND: Chronic, long-lasting edema accompanied by the Tyndall effect as a delayed reaction to hyaluronic acid (HA) filler injection seems to occur exclusively in the eyelids. OBJECTIVES: To present a treatment algorithm for management of patients with chronic lower eyelid edema as a delayed complication of HA filler injection. METHODS: Retrospective study including 61 patients with delayed-onset chronic periocular edema following uneventful HA filler injection in the lower eyelids or cheeks. All patients underwent hyaluronidase enzyme dissolution followed by secondary treatment. Three retreatment options were presented: (1) observation; (2) secondary treatment with HA filler; and (3) lower eyelid blepharoplasty. RESULTS: All patients underwent filler dissolution using hyaluronidase. The mean age was 48 years and 97% of the patients were female. Single treatment was effective in 92% of patients with 8% requiring another hyaluronidase injection to completely eradicate residual edema. Six patients (10%) were satisfied after hyaluronidase only and six patients (10%) underwent lower eyelid blepharoplasty. Secondary treatment with HA filler was performed in 48 patients (80%). All were satisfied with final results without further edema in the follow up period. CONCLUSIONS: Delayed-onset chronic lower eyelid edema is a frequent HA-related complication and cause of patient and practitioner concern when considering periocular HA treatment. Previous treatment has been limited to either hyaluronidase only or blepharoplasty as a secondary solution after hyaluronidase, with only a minority of patients satisfied with this regimen; our results highlight the importance of an effective, non-invasive alternative after filler dissolution. Hyaluronidase, shortly followed by HA filler retreatment, is a safe and effective solution.
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|Titolo:||Rehabilitation of the Dysmorphic Lower Eyelid From Hyaluronic Acid Filler: What to Do After a Good Periocular Treatment Goes Bad.|
|Data di pubblicazione:||2020|
|Appare nelle tipologie:||01.01 - Articolo su rivista|