COMPLICATIONS



If the injection protocol is strictly obeyed, the rate of complications of META<>CRILL® is extremely low.
The injection in cylindrical form avoids the formation of spherical capsules, in which the retraction rate is higher.

In a low number of patients, precisely 0,08% of the total, there was formation of nodules in areas of implants, almost always in the nasolabial folds.

These nodules are not painful, and were palpable and even visible. They were treated by puncture with a 1½ mm needle in a 5cc syringe where vacuum was formed, as in liposuction. With this maneuver, one can remove the content from inside of some of these nodules. Other more objective forms of treatment are the intra and peri-lesional corticosteroid infiltration.

The nodules could be removed surgically if the above procedures don’t work, trough small incisions.

Another complication is an inflammatory reaction in the implant site, appearing months or even years latter. This is related to an inflammatory response to an adjacent inflammatory process, as a tooth abscess, for example. Cured the original process, the inflammatory reaction will disappear.

A kind of complication derived from lack of anatomical knowledge of the surgeon, associated to the use of needles in specific areas, is the so called “ Nikolaou Syndrome”

In the beginning described as a consequence of intramuscular antibiotics, is was extended to use of implants. It is the consequence of intravascular or intramural injections of a product, with thrombosis and tissue suffering, with necrosis in some cases.

With META<>CRILL® this accident is observed in two areas: glabella and nasolabial folds.

In the glabella, by the presence of supratroclear veins immediately under the glabellar wrinkles. An implant in this place can promote the introduction of the product into the supratroclear vein, with consequent thrombosis of the supraophtalmic vein, loss of vision, lesions of orbital fat and extrinsic ocular muscles. This way it is forbidden the implant of META<>CRILL® in this region, and we must use some intradermal implant to treat these wrinkles.

In the nasolabial fold the accident is caused by penetration of implant in the facial vessels, which are located deep in the region. The consequence of thrombosis of these vessels is the nose alla necrosis and part of genian region, by vascular obstruction, isquemia, necrosis and secondary infection. Such accident can be strongly minimized by use of sharp canolas in this region. It is mandatory the knowledge of region anatomy, mainly regarding the facial vessels position.