Review of sterility of reused stored dermal filler

Hyaluronic Acid Fillers, Needle Contamination by Fastidious Microorganisms, and Risk of Complications

BACKGROUND

Complications are becoming ever more common with the increased use of hyaluronic acid (HA) fillers in aesthetic medicine. Complications due to needle contamination with fastidious microorganisms are no exception.

OBJECTIVE

To perform, in a top Italian aesthetic medicine facility, what the authors think is the first monitoring program of microbial needle contamination of cross-linked HA gel fillers after the prefilled syringes with gel residues were stored for retouches after the first aesthetic procedure.

METHODS

Needle contamination monitoring study, performed between January and November 2019, on 35 needles (caliber, 30 and 27 G) stored at 4°C in their resealed filler packages for possible retouch after a first aesthetic treatment involving the middle and lower facial thirds. Women's age: 35 to 70 years old.

RESULTS

The search for contaminating agents of the 3 monitored bacterial contaminants ( Staphylococcus aureus , Streptococcus pyogenes , and anaerobes) as well as yeasts and molds always tested negative. In the days and months after treatment, no patients in post-treatment controls showed evidence of infection in the treated areas.

CONCLUSION

The observational retrospective study confirms that good storage conditions, including monitored refrigeration, avoid the risk of contamination of partially used HA gel fillers by fastidious microorganisms.

A Rare Case of Migration of Hyaluronic Acid Gluteal Injection to the Medial Thigh Presenting as a Soft Lump

Introduction Hyaluronic acid (HA) is a widely accepted agent most commonly used as a dermal filler in facial aesthetic/cosmetic medicine. More recently, HA has been utilized for gluteal augmentation. The common side effects of HA injection are often minor and self-limiting. HA migration is a very rare complication.

Case Report We describe a rare case of HA buttock injection migration in a transgender patient, appearing as a superficial lump on right thigh representing a diagnostic dilemma. We highlight the need of a clinical suspicion and discuss the appropriate investigations for guided management of such patients.

Conclusion It is essential for reporting radiologist to be aware of the commonly used injectable fillers, their complications, and imaging findings to avoid misdiagnosis and guide optimal patient management.

An unusual and delayed complication of hyaluronic acid filler injection: a case report

48-year-old female with facial granulomatous nodules and fungal/bacterial infection after hyaluronic acid injection. She underwent anti-fungal/antibacterial therapy and local excision. The proposed mechanisms include inflammatory foreign body reaction and pathogen contamination. Providers must exercise caution with the use of facial fillers and demonstrate expertise in avoiding and managing potential complications.