Complications associated with injectable soft-tissue fillers: a 5-year retrospective review.

IMPORTANCE Even when administered by experienced hands, injectable soft-tissue fillers can cause various unintended reactions, ranging from minor and self-limited responses to severe complications requiring prompt treatment and close follow-up. OBJECTIVES To review the complications associated with injectable soft-tissue filler treatments administered in the Williams Rejuva Center during a 5-year period and to discuss their management. DESIGN AND SETTING Retrospective medical record review in a private practice setting. PARTICIPANTS Patients receiving injectable soft-tissue fillers and having a treatment-related complication. INTERVENTIONS Injectable soft-tissue filler treatments. MAIN OUTCOME MEASURES A retrospective medical record review was conducted of patients undergoing treatment with injectable soft-tissue fillers between January 1, 2007, and December 31, 2011, and identified as having a treatment-related complication. RESULTS A total of 2089 injectable soft-tissue filler treatments were performed during the study period, including 1047 with hyaluronic acid, 811 with poly-L-lactic acid, and 231 with calcium hydroxylapatite. Fourteen complications were identified. The most common complication was nodule or granuloma formation. Treatment with calcium hydroxylapatite had the highest complication rate. CONCLUSIONS AND RELEVANCE Complications are rare following treatment with injectable soft-tissue fillers. Nevertheless, it is important to be aware of the spectrum of potential adverse sequelae and to be comfortable with their proper management. LEVEL OF EVIDENCE 4.