• Complication Management

    Dermal Fillers (Hyaluronic Acid gel fillers)

Hyaluronic Acid Fillers are a safe and versatile product that can be used for great effect when used in the right hands.

Unfortunately Hyaluronic Acid Dermal Fillers are classified as medical devices in the UK. They are not classified as Prescription ONLY MEDICATION (POM).

As such technically anybody can administer a dermal filler in the UK. The overwhelming majority of medical professionals in the UK believe that this should not be the case. Understanding how to use a dermal filler safely and effectively requires a in depth understanding of the anatomy of the face. In particular the blood supply of the face must be well understood as it is possible to block important blood vessels with fillers.

Complications of Hyaluronic Acid Dermal Fillers include:

  • Temporary redness and swelling (all cases)
  • Bruising – 1 in 10 cases
  • Granuloma/Nodule formation – 1 in 1000 cases
  • Blood vessel blockage (resulting in skin necrosis and scar if not urgently treated) – 1in 1000 cases
  • Blindness (migration of filler from arteries around the nose and frown area to the central retinal artery) – 1 in 10000 cases (high risk areas are Nasal injection and Glabella injection)
  • Infection/biofilm – 1 in 2000 cases (if appropriate technique and preparation agents used)

Fillers that are administered by untrained individuals can cause necrosis (death of skin) that results in irreversible scarring. Fillers administered into blood vessels have also been found in post mortem studies in the blood vessels of the lung:

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This would have got into the circulation via injection of large amounts of filler into large veins of the face.

Untrained individuals such as beauty therapists who undertake these procedures have insufficient understanding of anatomy. Complications can arise even in treatments performed by medical professionals.

Doctors performing these procedures understand how to manage these complications. Having a procedure like this performed with a medically trained professional such as a Doctor means that there is recourse to safe management if a problem arises. You can also be reassured that Doctors carry adequate insurance cover to carry out these procedures. This is because this is a registration requirement for the GMC. Untrained individuals who do not have to have a licence to practice via a professional regulator like the GMC may not have adequate insurance cover.

Complication Management by Dr Hussein

It is unfortunate that many hyaluronic acid filler injections that have been performed by non- medical professionals result in sub-optimal outcomes and complications. It is often that Dr Hussein is approached by clients who have had a sub-optimal outcome or have experienced a complication from treatment by another practitioner. A common scenario is that when the client has tried to contact the original practitioner regarding the complication or suboptimal outcome it has been difficult to get in touch. Often they are unable to get in touch with the practitioner or they are told that nothing can be done and they should wait for ‘things to wear off’.

In the first instance Dr Hussein does not like to undertake corrections of another practitioner’s work. He firmly believes that sub-optimal outcomes management, corrective work and complications management should be undertaken by the original practitioner. This allows the original practitioner an opportunity to assess his/her own work and optimise the outcome. This will be an important learning experience for the original practitioner and also will be free of charge to the client.

In exceptional cases Dr Hussein may agree to assess and manage complications. Where urgent intervention is required for example. If Dr Hussein agrees to undertake this work then there will be a consultation charge and a fee for remedial work.

It goes without saying that Dr Hussein would manage any sub-optimal outcome or complication arising from his own work free of charge.

Costs of remedial work from outcomes related to other practitioners

  • Consultation & assessment: £150
  • Letter to original practitioner: £125
  • Cost of hyalase dissolving procedure: £250
  • Pulsed Dye Laser to speed resolution of Bruising: £335
  • Cost of remedial work: charged according to filler products used
  • Cost of steroid injections for treatment of late onset nodules: £150