Adverse Effects of Calcium Hydroxylapatite as a Cosmetic Filler and Therapeutic Alternatives: A Systematic Review
DOI:
https://doi.org/10.22517/25395203.25733Keywords:
Calcium hydroxylapatite, Dermal fillers, Complications, Adverse effects, Sodium thiosulfate, Dilution, Systematic reviewAbstract
Introduction: The use of calcium hydroxylapatite (CaHA) as a dermal filler has become a common procedure in facial aesthetic medicine due to its biostimulatory capacity and non-surgical lifting effect. However, its application may lead to adverse complications of varying severity, requiring proper management by healthcare professionals.
Objective: To conduct a systematic review of the adverse effects associated with the use of calcium hydroxylapatite as a cosmetic filler and the available therapeutic alternatives for their management.
Methods: A literature search was performed in PubMed, SciELO, Dialnet, and Google Scholar databases, following PRISMA methodology guidelines. Articles published in the last ten years, in Spanish and English, addressing adverse effects related to CaHA application and its treatment options were included. A total of 25 articles were selected after applying eligibility and exclusion criteria.
Results: The most frequently reported adverse effects include dermal nodules, erythema, ecchymosis, edema, and dysphonia, as well as major complications such as skin necrosis and vision loss. Therapeutic strategies described in the literature include the use of sodium thiosulfate (Na₂S₂O₃), dilutions with lidocaine and/or saline solution, combined techniques of collagenase ultraphonophoresis and thiosulfate diadynophoresis, as well as the application of vectorized patterns to optimize product distribution and minimize complications.
Conclusion: Calcium hydroxylapatite is a safe material when properly administered; however, its application requires a thorough knowledge of facial anatomy, proper injection techniques, and effective protocols for the prevention and management of complications. The dissemination of evidence-based therapeutic strategies is essential to improve the safety of these procedures in clinical practice.
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