Avoiding dermal filler complications

Age-related volume loss; increased skin laxity, fat loss, and redistribution; and diminished support from underlying muscle and bone result in the observable and sometimes profound changes seen in the aging face. Aging also is associated with functional changes in the skin, such as dermal atrophy with diminished fibroblastic activity, decreased collagen production, and altered clastin. Dermal fillers, such as bovine, human, and purified porcine collagen; hyaluronic acids; calcium hydroxylapatite; and injectable medical devices (eg, poly-L-lactic acid), are used commonly for facial rejuvenation. Soft-tissue augmentation with fermal fillers and injectable medical devices has gained widespread acceptance as an alternative to more aggressive, invasive treatment of the aging face. Technique, knowledge, expertise with fillers, proper patient assessment, a well-formulated treatment plan with access to agents for superficial, moderate, and deep rhytides, and volume restoration provide the necessary ingredients for optimal soft-tissue augmentation while minimizing complications.