Complications in Aesthetic Procedures: Insights from Dr. Shah-Desai

The content of this blog is designed and intended for the education of Healthcare Professionals

In our rapidly evolving industry, the use of hyaluronic acid (HA) fillers for facial enhancement is always on the rise. However, with innovation comes challenges. Fresh Clinics Members recently heard invaluable insights from Dr. Sabrina Shah-Desai, an internationally recognised expert in non-surgical and advanced cosmetic procedures on the prevention and management of complications associated with (HA) filler use.

Understanding the Anatomy

To optimally leverage fillers in aesthetics, an understanding of facial planes and the distribution of facial vasculature is a must. Enlightening us on this, Dr. Shah-Desai reinforced, "Prevention strategies are really important to understanding that depth of injection, injecting slowly, considering a cannula except in the nose, injecting small, and considering directing the needle perpendicular to the vessels."

Patient Assessment 

Sabrina made sure to emphasise the importance of patient assessment and consultation in the following order to minimise risks during treatment:

1. Take a detailed medical history
2. Take a detailed aesthetic history (types of filler used/dates of treatment)
3. Assess for any ongoing skin conditions, dental issues, and ear, nose, or throat issues
4. Establish if there is any severe pain or redness in past treatments
5. Establish duration and onset of “the lump”

One of the main risks associated with HA filler injections is the threat of vascular events. How we handle such events can make a significant difference in the patient's outcome. Complications ranging from infections to nodules and even blindness can occur, hence having a well-trained team in place, armed with the necessary tools and medications, is crucial.

"Anatomy and assessment of patient selection is a prerequisite for minimising the risk of complications. Never inject against resistance and considering the product is really important, particularly to prevent complications," said Dr. Shah-Desai, reinforcing the importance of comprehensive knowledge in filler treatments.

Navigating Complications

The importance of early detection, diagnosis, and management of adverse events cannot be overemphasised. For infections, the use of antibiotics might be considered while Hyaluronidase could be employed for treating nodules. Here, using ultrasound devices on patients would offer compelling advantages.

Aging and Filler Placement

Our skin undergoes transformations with age, leading to structural support and surface alterations. Sabrina shed light on this, highlighting "When we look at the surface topographical changes of aging we see this on the skin sort of from the ages of late 20s to mid 30s."

The awareness of these changes, especially in the mid-face and bony areas, forms the underpinning for informed decisions on filler placement and selection in patients. 

The 4D Approach 

Steering away from static notions, Sabrina introduced the concept of the 4D approach for optimising results with filler. This approach unravels a more holistic outlook in evaluating and enhancing facial features, acknowledging the dynamic fat pads and movements that define our faces.

The 4D approach is based on four key strategies and can have fewer complications, plus more revenue for your practice than filler alone: 

1. Protection (eg, sunscreen and antioxidants)
2. Promotion of cell turnover (eg, peels and laser)
3. Collagen stimulation
4. Volume remodelling (eg, fillers)

Empowering Your Practice

Sabrina's enlightening session contextualises the importance of preparedness at each step of aesthetic treatments. 

The core takeaway from Dr. Shah-Desai resonates with Fresh Clinics’ belief that knowledge and awareness are the foundation of excellence in aesthetics. By embracing these insights, we can look forward to an exciting future in advanced technology.

Stay tuned for more inspiring discussions. 

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