Zoya Diwan1,2,3,4,5,6,7,8,9,10, Sanjay Trikha1,2,3,4,5,6,7,8,9,10, Sepideh Etemad-Shahidi1,2,3,4,5,6,7,8,9,10, Surbhi Virmani1,2,3,4,5,6,7,8,9,10, Catherine Denning1,2,3,4,5,6,7,8,9,10, Yusra Al-Mukhtar1,2,3,4,5,6,7,8,9,10, Christopher Rennie1,2,3,4,5,6,7,8,9,10, Amanda Penny1,2,3,4,5,6,7,8,9,10, Yalda Jamali1,2,3,4,5,6,7,8,9,10, Nina Cassandra Edwards Parrish1,2,3,4,5,6,7,8,9,10. 1. Dr. Diwan is President of Academic Aesthetics Mastermind Group and the medical director of Trikwan Aesthetics in London, United Kingdom. 2. Dr. Trikha is Vice President of Academic Aesthetics Mastermind Group and the director of Trikwan Aesthetics in London, United Kingdom. 3. Dr. Etemad-Shahidi is a member at Academic Aesthetics Mastermind Group and a practitioner at Medicetics in London, United Kingdom. 4. Dr. Virmani is a member of Academic Aesthetics Mastermind Group and is with Cosderm in London, United Kingdom. 5. Dr. Denning is a member of Academic Aesthetics Mastermind Group and a director of Clinic 1.6 in London, United Kingdom. 6. Dr. Al-Mukhtar is a member of Academic Aesthetics Mastermind Group and a director at Dr. Yusra Clinic in London, United Kingdom. 7. Dr. Rennie is a member of Academic Aesthetics Mastermind Group and a director at Romsey Medical Aesthetics in Winchester, United Kingdom. 8. Dr. Penny is a member of Academic Aesthetics Mastermind Group and a doctor at Courthouse Clinics in London, United Kingdom. 9. Dr. Jamali is a member of Academic Aesthetics Mastermind Group and a clinic education fellow at Harley Academy in London, United Kingdom. 10. Dr. Parrish is a member of the Academic Aesthetics Mastermind Group and Trikwan Aesthetics in London, United Kingdom.
Abstract
With the number of aesthetic soft tissue filler treatments rapidly increasing, we have witnessed an increase in complications associated with such treatments. While rare, abscesses can arise as a result of these treatments, and current detailed guidelines do not exist detailing exactly how to manage them. OBJECTIVE: Our aim was to develop evidence-based and experience-based guidelines on how to, specifically, manage abscesses secondary to hyaluronic acid dermal fillers. METHODS: A thorough MEDLINE literature search of keywords, including abscess, abscess management/treatment, hyaluronic acid, dermal fillers, and soft tissue fillers, was completed to collect specific cases of abscesses secondary to soft tissue filler. Inclusion criteria involved papers published from 2010 to 2020 that focused specifically on soft tissue fillers in the face. In addition, we looked at papers that discussed abscesses secondary to soft tissue fillers in general and their management. We also reported three cases of abscesses secondary to hyaluronic acid dermal fillers that have been described by three different practitioners, detailing their history, examination, management, and outcomes. Experience and evidence have been collated to produce management guidelines. RESULTS and CONCLUSION: It is clear that each case is unique, but there is no current universal consensus on the risk assessment before treatment nor general management of abscesses secondary to soft tissue filler. The majority of the reports and cases discussed in the paper suggested the use of co-amoxiclav along with a macrolide or quinolone for at least two weeks. Incision and drainage are universally accepted as gold standard management. Microbiology, sensitivities, and cultures are also recommended. Hyaluronidase use, while controversial, is encouraged in effectively managing abscesses secondary to hyaluronic acid dermal filler.
With the number of aesthetic soft tissue filler treatments rapidly increasing, we have witnessed an increase in complications associated with such treatments. While rare, abscesses can arise as a result of these treatments, and current detailed guidelines do not exist detailing exactly how to manage them. OBJECTIVE: Our aim was to develop evidence-based and experience-based guidelines on how to, specifically, manage abscesses secondary to hyaluronic acid dermal fillers. METHODS: A thorough MEDLINE literature search of keywords, including abscess, abscess management/treatment, hyaluronic acid, dermal fillers, and soft tissue fillers, was completed to collect specific cases of abscesses secondary to soft tissue filler. Inclusion criteria involved papers published from 2010 to 2020 that focused specifically on soft tissue fillers in the face. In addition, we looked at papers that discussed abscesses secondary to soft tissue fillers in general and their management. We also reported three cases of abscesses secondary to hyaluronic acid dermal fillers that have been described by three different practitioners, detailing their history, examination, management, and outcomes. Experience and evidence have been collated to produce management guidelines. RESULTS and CONCLUSION: It is clear that each case is unique, but there is no current universal consensus on the risk assessment before treatment nor general management of abscesses secondary to soft tissue filler. The majority of the reports and cases discussed in the paper suggested the use of co-amoxiclav along with a macrolide or quinolone for at least two weeks. Incision and drainage are universally accepted as gold standard management. Microbiology, sensitivities, and cultures are also recommended. Hyaluronidase use, while controversial, is encouraged in effectively managing abscesses secondary to hyaluronic acid dermal filler.
Authors: Catherine Liu; Arnold Bayer; Sara E Cosgrove; Robert S Daum; Scott K Fridkin; Rachel J Gorwitz; Sheldon L Kaplan; Adolf W Karchmer; Donald P Levine; Barbara E Murray; Michael J Rybak; David A Talan; Henry F Chambers Journal: Clin Infect Dis Date: 2011-02-01 Impact factor: 9.079
Authors: Jonathan A Kadouch; Daniel J Kadouch; Shai Fortuin; Leo van Rozelaar; Refaat B Karim; Rick Hoekzema Journal: Dermatol Surg Date: 2013-10 Impact factor: 3.398
Authors: Fernando Urdiales-Gálvez; Nuria Escoda Delgado; Vitor Figueiredo; José V Lajo-Plaza; Mar Mira; Antonio Moreno; Francisco Ortíz-Martí; Rosa Del Rio-Reyes; Nazaret Romero-Álvarez; Sofía Ruiz Del Cueto; María A Segurado; Cristina Villanueva Rebenaque Journal: Aesthetic Plast Surg Date: 2018-01-05 Impact factor: 2.326