Safety and Potential Complications of Facial Wrinkle Correction with Dermal Fillers: A Systematic Literature Review.

: The history of facial fillers is very broad, ranging from the use of various materials to modern technologies. Although procedures are considered safe, complications such as skin inflammation, infection, necrosis, or swelling may occur. It is crucial for specialists to be adequately prepared, inform patients how to prepare for corrective procedures, adhere to high safety standards, and continually educate. The goal of this systematic review is to identify complications arising during facial wrinkle correction procedures, as well as to explore safety and potential prevention strategies. : The review of the scientific literature followed the PRISMA guidelines. The search was performed in a single scientific database: PubMed. Considering predefined inclusion and exclusion criteria, articles evaluating the safety of dermal fillers used for facial wrinkle correction, complications, and treatment outcomes were selected. The chosen articles were published from 15 February 2019 to 15 February 2024 (last search date: 25 February 2024). The selected articles compared the complications, product safety, and result longevity of various dermal fillers used for facial wrinkle correction. : In thirty-eight articles, which involved 3967 participants, a total of 8795 complications were reported. The majority of complications occurred after injections into the chin and surrounding area (n = 2852). Others were reported in lips and the surrounding area (n = 1911) and cheeks and the surrounding area (n = 1077). Out of the 8795 complications, 1076 were adverse events (AE), including two severe AE cases: mild skin necrosis (n = 1) and abscess (n = 1). There were no cases of vascular occlusion, visual impairment, or deaths related to the performed procedures. A total of 7719 injection site reactions were classified as mild or temporary, such as swelling (n = 1184), sensitivity (n = 1145), pain (n = 1064), bleeding (n = 969), hardening/stiffness (n = 888), nodules/irregularities (n = 849), and erythema (redness) (n = 785). : Facial wrinkle correction procedures are generally safe and effective and the results can last from 6 to 24 months, depending on the dermal filler material and its components used. The most common complications after dermal filler injection usually resolve spontaneously, but if they persist, various pharmacological treatment methods can be used according to the condition, and surgical intervention is generally not required.