RESUMO
BACKGROUND: Hyaluronic acid fillers have a satisfactory safety profile. However, adverse reactions do occur, and rarely intravascular injection may lead to blindness. Currently there is no internationally recognized consensus on the prevention or management of blindness from hyaluronic acid filler. OBJECTIVES: The authors sought to give guidance on how to minimize the risk and optimize the management of this rare but catastrophic adverse reaction. METHODS: A multinational group of experts in cosmetic injectables from multiple disciplines convened to review current best practice and develop updated consensus recommendations for prevention and bedside intervention if visual loss occurs after cosmetic injection of hyaluronic acid filler. RESULTS: The consensus group provided specific recommendations focusing on the consenting process, prevention, and early management of visual impairment related to intravascular hyaluronic acid filler injection. CONCLUSIONS: Although visual loss due to filler injections is rare, it is important that both patient and physician be aware of this risk. In this paper the authors describe methods and techniques available to reduce the risk and also document suggested initial management should a clinician find themselves in this situation.
Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Cegueira/induzido quimicamente , Cegueira/prevenção & controle , Consenso , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Humanos , Ácido Hialurônico/efeitos adversosRESUMO
OBJECTIVE: To determine the clinical correlates of dysmorphic concern in persons seeking cosmetic enhancement from cosmetic physicians. METHOD: A questionnaire survey of 137 patients attending the practices of two cosmetic physicians. RESULTS: Four subjects (2.9%; 95% CI = 0.8%-7.3%) had a diagnosis of body dysmorphic disorder (BDD), but many more expressed overconcern with physical appearance ('dysmorphic concern'). Dysmorphic concern accounted for a substantial amount of the variance for mood, social anxiety, and impairment in work and social functioning, while concerns related to how self or others perceive the putative flaw in appearance, impacted significantly on work and leisure activities, but did not apparently influence mood and social anxiety to any significant degree. CONCLUSIONS: Dysmorphic concern is a broad dimensional construct that is related to both inter- and intrapsychic distress and disablement associated with people seeking cosmetic enhancement