Management of Permanent Filler Complications Using Deep-Plane Facelift and Temporoparietal Fascial Flap Reconstruction: A Retrospective Study.

[BACKGROUND] Permanent fillers can lead to long-term complications, including granulomas, infections, and migration. Their removal often causes significant facial defects, posing challenges in reconstructive surgery.

[OBJECTIVES] The authors of this study aim to evaluate the clinical outcomes of deep-plane facelifts combined with temporoparietal fascial flap (TPFF) reconstruction in managing complications and restoring aesthetics following permanent filler removal.

[METHODS] This retrospective study included 160 patients who underwent deep-plane facelifts with permanent filler removal and TPFF reconstruction between 2014 and 2022. Those with unrealistic expectations, BMI >30, a recent infection (≤3 months), or severe malar edema were excluded. The average follow-up period was 16 months (range, 6-68 months).

[RESULTS] Of 160 patients (149 females, 11 males; mean age 48 ± 8.4 years), 131 (82%) completed follow-up. The complication rate was 22%, including transient swelling and bruising (15%), minor infections (4%), and hematomas (3%). Psychological outcomes improved significantly, with increased self-esteem and social interaction scores and reduced anxiety and depression levels. Hospital stays averaged 32 h (range, 24-48 h).

[CONCLUSIONS] TPFF reconstruction during deep-plane facelifts is a reliable approach for addressing complications and defects following permanent filler removal. This technique provides reliable reconstruction and improved outcomes, with promising long-term stability. Further research is warranted to refine these methods and optimize patient care.