Managing intravascular complications following treatment with calcium hydroxylapatite: An expert consensus

• DOI: 10.1111/jocd.13353
• Publication Date: 2020-03-18T11:48:56Z
• Authors: Jani van Loghem; David Funt; Tatjana Pavicic; Kate Goldie; Yana Yutskovskaya; Sabrina Fabi; Pieter Siebenga; Job Thuis; Joseph Hkeik; Jonathan Kadouch; Welf Prager; Nabila Azib; Gabriela Casabona; Steve Dayan; Shino Bay Aguilera; Philippe Snozzi; Peerooz Saeed
• Keywords: Expert opinion; Vascular occlusion

Abstract Background Inadvertent intra‐arterial injection of dermal fillers including calcium hydroxylapatite (CaHA) can result in serious adverse events soft tissue necrosis, permanent scarring, visual impairment, and blindness. When occurs, immediate action is required for optimal outcomes, but the infrequency this event means that many physicians may never have experienced scenario. The aim document to provide evidence‐based expert opinion recommendations recognition management vascular compromise following inadvertent CaHA. Methods An international group experts with experience CaHA complications was convened develop a consensus on injection. members were asked preventative advice avoidance intravascular produce treatment protocol acute delayed presentation. To ensure all relevant options included, supplemented PubMed search literature. Results For prevention injection, outlined importance thorough knowledge facial anatomy patient history, as well highlighting potential risk zones techniques. Individual sections how recognize symptoms occlusion leading vision loss necrosis detailed protocols these events. impending are provided early presentations follow‐up treatment. A separate section details open closed wounds. Conclusions All should be prepared eventuality filler, despite its rarity. These combine from aesthetic latest reports published literature an up‐to‐date office‐based arising