We have this idea that all the problems have started recently including vascular occlusion but we have been dealing with these problems for a long time.  We will show about 30 cases in this webinar to give you an idea of aesthetic complications in the last 20 years.

The first case is about a 39 years old female who presented with botulinum induced ptosis 5 days after Botox injection in her forehead for cosmetic purposes in 1999. She was unable to keep her eyes open and was unable to drive. Apraclonidine 0.5% drops were used. Within twenty minutes, an improvement of 3mm in right eyelid elevation was noted.

In 1992-1998 one of the biggest problems happening in the world was HIV and at that time patients were been treated with Sculptra. One of the problems was that the patients came from all around the world to the UK for treatment and you could easily have contact with their blood. So we were looking to decrease the risk of a needle stick. At that time Sculptra was being used and we had to give the patient 3-5 treatments three weeks apart. You could have a patient that needed 35 injections on each side of her face and a total of 70 injections so you could get a needle stick quite easily. Dr. Patrick Treacy came up with a technique to use one entry point.

By 2002 HIV had caused immense human suffering on the African continent. The most obvious effect was illness and death, but the impact was not confined to the health sector: households, schools, workplaces, and economics became badly affected. With support from donors, TASO provided comfort and palliative care to HIV+ people at home, allowing many to live a few extra months and die in dignity. But for most, life-saving ARVs were not available.  According to a study, the immediate benefits of a polyalkylimide gel in the correction and restoration of facial contour in subjects having severe HIV-related facial lipodystrophy were demonstrated. This improvement was still noted at 18 months. The efficacy, ease of injection, and safety profile of polyalkylimide gel made this filling material a potentially attractive treatment for lipodystrophy.

Hyalase (Hyaluronidase) is an enzyme produced naturally by the body. It temporarily and reversibly breaks down the natural polysaccharide hyaluronic acid, which is a type of glue found between mammalian cells of connective tissue. Local irritation, infection, bleeding, or bruising at the injection site are some of the complications. Severe allergic reactions, including anaphylaxis, have also occurred rarely.