Publication
Intercorrências vasculares com ácido hialurónico associadas ao preenchimento labial: revisão narrativa
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Advisor(s)
Abstract(s)
O preenchimento labial é um procedimento, que integrado na Harmonização Orofacial, pode valorizar um sorriso estético em determinadas situações clínicas e, por se tratar de um procedimento minimamente invasivo, tem tido uma adesão crescente. A sua procura aumentou de 1,8 milhões de procedimentos em 2010 para 2,6 milhões em 2016, segundo a Sociedade Americana de Cirurgiões Plásticos dos Estados Unidos. O objectivo do presente trabalho é analisar e discutir as reações adversas e intercorrências associadas ao procedimento de preenchimento labial, salientando o determinante papel do conhecimento anatómico e do domínio das técnicas de execução clínica para aumentar a previsibilidade dos tratamentos e antecipação de possíveis complicações. Pretende-se realizar uma revisão narrativa da literatura, tendo por base a análise de descrição de casos clínicos com intercorrências aquando de preenchimento labial, num período de revisão de 10 anos (2013-2022). As complicações e eventos adversos nem sempre são reconhecidos, e, apesar de na sua maioria serem leves e transitórios, há aquelas mais graves, que podem incluir a necrose labial. Os efeitos adversos após o preenchimento labial com ácido hialurónico podem ser classificados de acordo com a gravidade, natureza ou de acordo com seu início. As complicações imediatas e precoces incluem equimoses, edemas, infecções, nódulos e comprometimento vascular. Para controlo das intercorrências é essencial compreender as características relevantes do produto utilizado, ter domínio da anatomia facial e das técnicas de injeção. Na maioria dos casos, a artéria labial pode encontrar-se superior à borda do vermelhão, sob o músculo orbicular da boca, com profundidade mínima de 3 mm, onde o preenchimento dérmico nesta profundidade evitaria as complicações críticas relacionadas ao procedimento citado, no entanto, as artérias labiais, superior e inferior, podem apresentar um padrão de curso variável. Os eventos adversos mais graves podem ocorrer, deixando o paciente com déficit funcional e estético permanente. Cabe ao clínico exercer o ato médico com segurança, assegurando ao paciente um tratamento eficaz, harmonioso e sem intercorrências permanentes.
Lip filling, an integral part of Orofacial Harmonization, has gained popularity as a minimally invasive procedure for enhancing the aesthetic appeal of smiles in specific clinical scenarios. The demand for this procedure has witnessed a steady increase, with 2.6 million procedures performed in 2016 compared to 1.8 million in 2010, as reported by the American Society of Plastic Surgeons. This study aims to analyze and discuss the adverse reactions and intercurrences associated with lip filling, highlighting the crucial role of anatomical knowledge and clinical execution techniques in improving treatment predictability and the early identification of potential complications. A narrative literature review was conducted, focusing on the analysis of clinical case descriptions involving complications during lip filling, spanning a review period of ten years (2013-2022). Although complications and adverse events may not always be readily recognized, it is essential to acknowledge their presence and promptly address them. While most complications are mild and transient, severe complications, including lip necrosis, can also occur. Adverse effects following lip filler procedures, particularly those involving hyaluronic acid, can be categorized based on their severity, nature, or onset. Immediate and early complications encompass ecchymosis, edema, infections, nodules, and vascular compromise. To effectively manage complications, a comprehensive understanding of the characteristics of the filler product employed, as well as proficiency in facial anatomy and injection techniques, is essential. In most cases, the labial artery is located superior to the vermilion border of the lip, beneath the orbicularis oris muscle, at a minimum depth of 3 mm. Administering dermal filler injections at this depth can help mitigate critical complications associated with the aforementioned procedure. However, it is important to note that the course pattern of the labial arteries, both superior and inferior, may exhibit variability. Serious adverse events can lead to permanent functional and aesthetic deficits for the patient. Therefore, it is incumbent upon the clinician to perform this medical intervention safely, ensuring an effective and harmonious treatment outcome, devoid of permanent intercurrences.
Lip filling, an integral part of Orofacial Harmonization, has gained popularity as a minimally invasive procedure for enhancing the aesthetic appeal of smiles in specific clinical scenarios. The demand for this procedure has witnessed a steady increase, with 2.6 million procedures performed in 2016 compared to 1.8 million in 2010, as reported by the American Society of Plastic Surgeons. This study aims to analyze and discuss the adverse reactions and intercurrences associated with lip filling, highlighting the crucial role of anatomical knowledge and clinical execution techniques in improving treatment predictability and the early identification of potential complications. A narrative literature review was conducted, focusing on the analysis of clinical case descriptions involving complications during lip filling, spanning a review period of ten years (2013-2022). Although complications and adverse events may not always be readily recognized, it is essential to acknowledge their presence and promptly address them. While most complications are mild and transient, severe complications, including lip necrosis, can also occur. Adverse effects following lip filler procedures, particularly those involving hyaluronic acid, can be categorized based on their severity, nature, or onset. Immediate and early complications encompass ecchymosis, edema, infections, nodules, and vascular compromise. To effectively manage complications, a comprehensive understanding of the characteristics of the filler product employed, as well as proficiency in facial anatomy and injection techniques, is essential. In most cases, the labial artery is located superior to the vermilion border of the lip, beneath the orbicularis oris muscle, at a minimum depth of 3 mm. Administering dermal filler injections at this depth can help mitigate critical complications associated with the aforementioned procedure. However, it is important to note that the course pattern of the labial arteries, both superior and inferior, may exhibit variability. Serious adverse events can lead to permanent functional and aesthetic deficits for the patient. Therefore, it is incumbent upon the clinician to perform this medical intervention safely, ensuring an effective and harmonious treatment outcome, devoid of permanent intercurrences.
Description
Keywords
Anatomia Vascularização labial Preenchimento labial Intercorrências Ácido hialurónico Anatomy Lip vascularization Lip filling Complications Hyaluronic acid