Dermatol. praxi. 2025;19(1):27-33 | DOI: 10.36290/der.2025.004

Non-vascular complications of hyaluronic acid-based fillers

MUDr. Kateřina Klauzová, MBA

Asklepion, Institut laserové a estetické medicíny, Praha

Aesthetic interventions using hyaluronic acid-based filler materials are now widespread worldwide. However, this phenomenon also brings with it problems. Uncontrolled production and variation in the quality of fillers. Application of fillers by non-experts. Increasing incidence of adverse reactions and complications. Vascular complications can be very serious or even fatal. Due to rapid globalization and the rise of social media, there is a shift in the perception of beauty across generations. Therefore, it is essential for the physician to be able to identify the patient's motivation and differentiate between what the patient wants and what he or she actually needs and transform exaggerated expectations into realistic goals (1). Complications associated with the application of dermal fillers are commonly divided into four basic categories: hypersensitivity reactions, vascular events, infections, and delayed inflammatory changes. Another division considers the time course into acute (vascular occlusion, inflammatory reactions, injection-related reactions, spread of material) and delayed (inflammation, nodular lesions, dyspigmentation, dislocation of the filler). The article deals only with non-vascular complications and for clarity divides them into hypersensitivity reactions (allergy), infections, nodules, edema, skin discoloration and others. For optimal management of adverse effects, it is essential to have a practical and clear protocol with a decision-making algorithm. Interdisciplinary collaboration should also be part of safe practice.

Keywords: hyaluronic acid, filler complications, ASIA syndrome, hypersensitivity, non-vascular filler complications, nodules, late allergic reaction, late bacterial infection, filler migration.

Accepted: April 11, 2025; Published: April 17, 2025  Show citation