What to do when injections go wrong?
Complications can also arise with injections. We talked about this in a VIDEO interview with Dr. Sonja Sattler. She is the co-founder of Rosenpark Klink and looks back on more than 20 years of experience.
From your point of view, what are the biggest problems with injections with fillers?
“For one thing, you sometimes see grotesque overcorrections, which is because too much material is injected too often. If the filler is not injected properly, it can lead not only to poor results and unnecessary bruising, but also to medical complications.”
Dr. Sonja Sattler: “Usually, fillers are injected down to the bone, where vessels, veins, arteries and nerves run along and thus a very good anatomical knowledge is required. Especially injections with hyaluron should not be performed by cosmeticians, but only by well-trained doctors.”
“It is very problematic if, for example, it is injected into a vessel that is then blocked. Then the retina of the eye can no longer be supplied and blindness occurs. For this reason, injections should only be performed by doctors who routinely perform these treatments and are constantly undergoing further training. Even young doctors are trained for a long time by experienced doctors and practice daily to be able to treat later as well.”
What can happen?
“Unsightly injections or overcorrections caused by too much hyaluronic acid tend to be harmless if the injection technique is correct, as the body breaks down the filler on its own. Hyaluronic acid can also be dissolved again with the antidote hylase. A major problem, on the other hand, is an intravascular injection, i.e. an injection into a vessel. A vessel allows blood to flow in or out. If this is blocked by the filler material, an undersupply occurs in the subsequent area and, in the best case, only a bruise can result or, in the worst case, skin necrosis and subsequent scarring. Nasal injections in particular are a difficult area because that’s where the vascular supply for the whole forehead runs along.”
How to protect yourself?
“First and foremost, by choosing the right doctor. Patients should inquire about how often a physician injects – ideally daily – and, what medical training he or she has. Surgical and anatomical knowledge of the physician is important because it minimizes the risk of injection mishaps in the first place. And if problems do occur, appropriately trained physicians can handle them more routinely. Moreover, the more qualified the physician, the less likely he or she is to use inferior products. In Germany, alternative practitioners are also allowed to inject fillers, as they are not part of the classic medication, but this is definitely not advisable, as alternative practitioners lack the anatomical knowledge and have hardly any further training opportunities in this area.”
Are there any other reasons for seeking treatment only from trained medical practitioners?
“Responsible doctors never look at the aesthetic problem in isolation, but as part of the medical history, explore whether there are any medical conditions or medications being taken that may cause problems in conjunction with the injections. A good doctor will also take time for a facial analysis and discuss an appropriate treatment concept with the patient. Then, of course, one should make sure that he also takes possible concerns seriously and offers other approaches besides standards such as nasolabial fold or lip injections, which make an individual approach to the face possible in the first place.”
Is there also such a thing as an emergency situation?
“When the filler is injected into a vessel, an emergency situation, in this case a vessel occlusion, can occur. Fast action is required here, as the connective tissue is no longer supplied with sufficient oxygen. For these cases, both the Rosenpark Clinic and Bellari have an ’emergency kit’. This consists of the enzyme hyaluronidase, which occurs naturally in the body and breaks down hyaluronic acid.”
This sounds pretty dramatic. How do you recognize this emergency situation?
“The skin discolorations change in stages from pale to bluish-purple, however, these are difficult for laypersons to assess. Therefore, again, it is important to rely on an experienced and experienced physician. With experienced physicians, vascular occlusions are almost non-existent, but basically you have the assurance that they can handle any complication.”
Photo by SvetlanaFedoseyeva/Shutterstock.com.