# Complications of Dermal Injectables—A Retrospective Study

## TL;DR

This study examines complications from dermal fillers, showing that unsafe practices and unapproved products can lead to serious health issues.

## Contribution

The study provides new insights into the risks of HA-based injectables when administered improperly or with unapproved products.

## Key findings

- Most complications arose from injections by unqualified individuals or with uncertified products.
- Common issues included biofilm formation, chronic immune reactions, and vascular occlusion.
- Over half of the products used were either uncertified or of unknown origin.

## Abstract

Hyaluronic acid (HA)‐based injectables are generally considered safe. However, short‐ and long‐term complications may occur.

To evaluate complications related to soft‐tissue augmentation presented to the Department of Dermatology at a university hospital.

A retrospective analysis was conducted using electronic medical records from January 2019 to January 2025. Adverse events related to HA‐based injectables, their management, and outcomes were identified and evaluated.

Thirty‐one patients (mean age: 50.4 years) were included in the analysis. Injections have been administered by cosmeticians (2/31), nonmedical practitioners (2/31), or individuals of unknown qualification. The most common complications were biofilm formation and chronic immune reactions, followed by abscesses, Tyndall effect, vascular occlusion, and filler migration. Over half of the products involved were either uncertified or of unknown origin.

The findings highlight the need for qualified practitioners, careful product selection, and adherence to standardized techniques. Enhancing practitioner education, establishing evidence‐based protocols, and strengthening regulatory oversight are essential to ensure patient safety in aesthetic medicine.