Soares DJ MD
Molecules (Basel, Switzerland). Date of publication 2022 Aug 24;volume 27(17):.
1. Molecules. 2022 Aug 24;27(17):5398. doi: 10.3390/molecules27175398.
Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of
HA Filler-Induced Vascular Occlusion (FIVO)-Implications for Therapeutic
Interventions.
Soares DJ MD(1)(2).
Author information:
(1)American Foundation for Aesthetic Medicine (AFFAM), Fruitland Park, FL 34731,
USA.
(2)College of Medicine, University of Central Florida, Orlando, FL 32827, USA.
Erratum in
Molecules. 2024 Dec 20;29(24):6006. doi: 10.3390/molecules29246006.
Biocompatible hyaluronic acid (HA, hyaluronan) gel implants have altered the
therapeutic landscape of surgery and medicine, fostering an array of innovative
products that include viscosurgical aids, synovial supplements, and drug-eluting
nanomaterials. However, it is perhaps the explosive growth in the cosmetic
applications of injectable dermal fillers that has captured the brightest
spotlight, emerging as the dominant modality in plastic surgery and aesthetic
medicine. The popularity surge with which injectable HA fillers have risen to in
vogue status has also brought a concomitant increase in the incidence of
once-rare iatrogenic vaso-occlusive injuries ranging from disfiguring facial
skin necrosis to disabling neuro-ophthalmological sequelae. As our understanding
of the pathophysiology of these injuries has evolved, supplemented by more than
a century of astute observations, the formulation of novel therapeutic and
preventative strategies has permitted the amelioration of this burdensome
complication. In this special issue article, we review the relevant mechanisms
underlying HA filler-induced vascular occlusion (FIVO), with particular emphasis
on the rheo-mechanical aspects of vascular blockade; the thromboembolic
potential of HA mixtures; and the tissue-specific ischemic susceptibility of
microvascular networks, which leads to underperfusion, hypoxia, and ultimate
injury. In addition, recent therapeutic advances and novel considerations on the
prevention and management of muco-cutaneous and neuro-ophthalmological
complications are examined.
DOI: 10.3390/molecules27175398
PMCID: PMC9458226
PMID: 36080164 [Indexed for MEDLINE]
Conflict of interest statement: The author is a speaker for Revance
Therapeutics, Inc. (Nashville, TN, USA).
