Periorbital venous stasis may be involved with filler induced malar edema—A duplex ultrasound-imaging-based case series

L. Schelke*, O. Liplavk, S. Cotofana, S. Shah-Desai, P. Velthuis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
102 Downloads (Pure)

Abstract

Introduction:

Filler injections in the periocular region are regarded as a challenging and advanced maneuver in a high-risk area. Adverse events as malar edema due to filler treatment may occur. To evaluate the possible reasons, the ultrasound images, and medical data of patients that were prospectively referred with malar edema were evaluated. 

Materials and Methods: 

A total of 17 patients (26 eyes) with malar edema after hyaluronic acid filler treatment were included. All cases were assessed with an 18 MHz linear ultrasound device. Exact location of the filler material was noted. Relations with clinical data were analyzed using chi-square tests. 

Results: 

Onset of malar edema after treatment showed a wide range from immediate (0 days) to 3 years. Most patients had an early onset N = 13 (76%), a minority showed late onset N = 4 (24%). In 23 eyes, the filler material was found to be located inside the SMAS. In 3 cases filler material was located on the periosteum of the orbital rim. After duplex-ultrasound guided filler removal, restored venous flow could be seen in the superficial and/or deep fatty layer often accompanied by flow piercing through the SMAS. Minutes after treatment, clinical improvement of malar edema was observed. 

Conclusion: 

Malar edema after by filler treatments in the periocular region may be caused by veno-lymphatic compression by filler deposits.

Original languageEnglish
Pages (from-to)3246-3251
Number of pages6
JournalJournal of Cosmetic Dermatology
Volume22
Issue number12
Early online date2 Oct 2023
DOIs
Publication statusPublished - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

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