Managing Complications in Facial Cosmetic Treatment.

[OBJECTIVE] To investigate the clinical and pathologic characteristics of adverse reactions after minimally invasive facial cosmetic treatment and to summarize diagnostic and therapeutic experiences, providing reference for clinicians.

[METHODS] Forty-five patients who experienced complications from minimally invasive facial cosmetic procedures and were treated at School and Hospital of Stomatology, Wuhan University between June 2014 and June 2024 were selected. A retrospective analysis was conducted on the diagnosis, treatment methods, and prognostic outcomes of these adverse reactions.

[RESULTS] The average age of patients is 41 years (26-63 y), including 44 females and 1 male. Injection/filler materials were recorded for 28 patients: 46.4% (n=13) received autologous fat, 17.9% (n=5) botulinum toxin, 17.9% (n=5) hyaluronic acid, 7.1% (n=2) thread lifting, and 3.6% (n=1 each) received combinations of botulinum toxin and hyaluronic acid, silicone prothesis implants, or polyacrylamide hydrogel. Clinically, 97.8% (n=44) experienced local swelling, predominantly in the cheek (73.3%, n=33). Ultrasound showed low-density echoes in 77.8% (n=7) and non-contrast CT scans revealed soft tissue density masses in 66.7% (n=10). Twelve patients underwent surgical excision after conservative treatment failed. Pathologic findings included foreign body granulomas in 63.6% (n=7), lipogranuloma in 9.1% (n=1), chronic nonspecific inflammation in 18.2% (n=2), and epithelial dysplasia in 9.1% (n=1). All 12 surgical patients and the 33 non-surgical patients had favorable outcomes.

[CONCLUSION] Adverse reactions to minimally invasive facial cosmetic procedures mainly occur in the cheeks of middle-aged women, often pathologically diagnosed as foreign body granuloma. Conservative treatment is the primary approach, but surgical excision is effective for unresponsive cases.