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Adverse reactions to fillers should be published – on the consensus statement on adverse effects following hyaluronic acid‐based fillers

2017; Wiley; Volume: 31; Issue: 7 Linguagem: Inglês

10.1111/jdv.14424

1468-3083

Berthold Rzany,

Facial Nerve Paralysis Treatment and Research

By Philipp-Dormston et al.1 Aesthetic procedures are two faced. On one side, we see fabulous or at least okay results and on the other side adverse reactions from – when it comes to fillers – abscesses to blindness. Thankfully, these adverse reactions are – for most fillers – rare. Being rare, however, makes things not easier as the knowledge on risk factors for adverse reactions and treatment of adverse reactions are based mostly on expert opinion – and experts might err. Therefore, to reduce errors and misconceptions, it is of uttermost importance that we publish these cases! Based on the discussed paper, the group has been treating several hundreds of patients with adverse reactions to fillers. These cases need to be accessible! Even a single case report as a quite recent one from Spain which points to an increased risk of hyaluronic acid (HA) fillers based on the Vycross technology is helpful. Specifically, as in this case report the delayed! filler reaction was reproducible in a skin test with the Vycross products the patient did receive before.2 This very simple case reports invalidates (in my humble expert opinion) all discussions on biofilm in HA fillers and instead points to an increased risk of a specific HA filler family. Besides the biofilm issue, the paper is as good as an expert consensus paper can be and should rise awareness to the dark side of HA fillers. Only one very small comment at last. What I did not understand was – why it was necessary to fund this consensus paper by two companies? This is a simple expert consensus guideline which in my opinion does not need external funding as it is not based on an extensive literature search. Being funded by only two companies raises further the question (honi soit qui mal y pense) if there was a specific interest behind for the two companies to fund this consensus.