皮肤填充剂在整形美容外科中的应用——不良事件及治疗方法概述

Application of Dermal Filler in Aesthetic Plastic Surgery——Overview of Adverse Events and Treatment Method

背景:越来越多的皮肤填充剂被应用于临床,这对患者和医生都是有益的。然而随着适应证的扩展及应用的增加,并发症的发生率也随之增长。目的:总结与皮下注射相关的不良事件,并为并发症的治疗与避免提供指导。方法:对皮肤填充剂相关的不良事件进行综述。以综述文献为基础,结合作者的日常工作经验,对预防和治疗不良事件提出相关建议。结果:不同的皮肤填充剂有各自的特点、风险和注射要求。皮肤填充剂都存在引起不良反应的可能,其中大部分与注射量和技术有关,也有一些与材料本身有关。短暂和轻微的不良反应,比如瘀伤和创伤相关水肿是最常见的。严重不良反应很少发生,依靠充分的计划和丰富的临床技术,大部分严重不良反应是可以避免的。结论:为了达到最好的注射结果,医生需要对面部解剖学、不同品种皮肤填充剂的特点、优势和不足有深入的了解,从而避免潜在的不良事件。

Background:A variety of dermal fillers for aesthetic soft tissue are being developed and used in clinics,which is beneficial for both patients and doctors.However with indications and procedures performed increasing,the number of complications will be likely to increase as well.Objective:To summarize the adverse events associated with dermal fillers,and to provide guidance on the treatment and avoidance of those adverse events.Methods:Adverse events associated with dermal fillers were reviewed.On the basis of the reviewed literature and the extensive experience from the authors'experience from daily work,recommendations for management and avoidance of adverse events are made.Results:Different dermal fillers have their own characteristics,associated risks and injection requirements.All dermal fillers have the potential to cause side effects,most of which are associated with injection volume and techniques,despite some are related to the material itself.Transient and mild side effects,as bruising and trauma-related edema are most common.Serious adverse reactions are rare,and most can be avoided by well-prepared planning and varieties of clinical techniques.Conclusions:To attain optimal results,doctors need master deep understanding of facial anatomy,the characteristics of varieties of dermal fillers,their indications,benefits and shortcomings,as well as means to avoid potential adverse events.