07 November 2025 : Review article
Facial Injectable Fillers in Aesthetic Medicine: Clinical Applications and Safety Strategies
Jie Liu A 1, Ming Gao EF 2, Huilin Hu CF 2, Hanyu Pang
BD 2, Yuyang Liu EF 2, Peng Zhang A 1*
DOI: 10.12659/MSM.949944
Med Sci Monit 2025; 31:e949944
Table 4 Overview of the complications of filler injection and management strategies.
| Adverse events | Common symptoms | Management |
|---|---|---|
| Injection site reactions | Erythema | Hyaluronidase, ice packs, topical steroids |
| Edema | Skin massage, hyaluronidase, icepacks, intralesional steroids, oral steroids | |
| Bruising | Skin massage, hyaluronidase, icepacks, intralesional steroids, oral steroids | |
| Pain/tenderness | Ice packs | |
| Infection | Nodule/abscess | Skin massage, hyaluronidase, intralesional steroids ±5-FU, oral steroids, oral antibiotics, minimal stab incision with evacuation, excision |
| Local edema | Skin massage, hyaluronidase, ice packs, intralesional steroids, oral steroids | |
| Technical and placement errors | Contour irregularities | Second operation |
| Filler migration | Removal of filler material | |
| Skin discoloration | Redness | Laser treatment can be used if necessary |
| Blueness | Hyaluronidase, minimal stab incision with evacuation of residual filler if persistent | |
| Hyperpigmentation | Topical use contains hydroquinone, methanol, retinoic acid, and other skin lighteners; oral tranexamic acid; if necessary, can also use intense pulsed light, pulsed dye laser or fractional laser treatment | |
| Vascular compromise | Blurred vision | Ophthalmic arterial injection of hyaluronidase and urokinase, retrobulbar space injection of corticosteroids and tobramycin, ocular massage, intravenous mannitol, acetazolamide, anterior chamber paracentesis, hyperbaric oxygen |
| Loss of vision | No management | |
| Vascular occlusion | Hyaluronidase, aspirin, skin massage, warm compresses, topical nitroglycerin paste | |
| Tissue necrosis | Antibacterial ointment, daily local wound care regimen with debridement, hyperbaric oxygen |