Safety in High-Volume Hyaluronic Acid Dermal Filler Injection with Perlane® for Facial Rejuvenation

Background: There have been concerns about the safety of using high-volume dermal fillers for the treatment of facial volume loss associated with aging¹. The aim of this study was to evaluate the use of high-volume hyaluronic acid (HA) dermal filler injections with Perlane® (Galderma, Fort Worth, TX) and evaluate the incidence of adverse reactions. 

Methods: The study evaluated patients with ages ranging from 38 to 88 years-old. A total of 19 patients were included in the study. One patient was male and 18 were female. High-volume injection was defined as greater than or equal to 6 cubic centimeters (cc) during a single treatment episode to a specific location. The amount of product injected ranged from 6 to 25cc. The regions of the face that were injected included periorbital and midface. Each patient was injected by the same provider using the same technique. Follow-up for each patient ranged from 12 to 36 months. Adverse reactions were defined as systemic or local allergic reaction, granuloma formation, nodules, infection, and/or tissue necrosis. 

Results: No adverse reactions were experienced with the use of high-volume HA dermal filler injection with Perlane®. A subset of patients experienced post-injection swelling, minimal bruising, and tenderness that resolved over 5-7 days. 

Conclusion: High-volume HA dermal filler injection with Perlane® is a safe technique that can be performed to a specific facial region. The lack of adverse reactions seen with this high-volume technique can allow providers to more aggressively treat local areas of deficient facial volume. The use of high-volume HA dermal filler can be safely tailored to enhance specific aesthetic subunits.    

References:

1. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol. 2013;6:295-316.

2. Cohen JL. Understanding, avoiding, and managing dermal filler complications. Dermatol Surg. 2008;34:92-99.

3. Park TH, Seo SW, Kim JK, et al. Clinical experience with hyaluronic acid-filler complications. J Plast Reconstr Aesthet Surg. 2011;64:892-896.