FACIAL INJECTABLE FILLERS IN AESTHETIC MEDICINE: A SYSTEMATIC REVIEW OF CLINICAL APPLICATIONS, SAFETY, AND COMPLICATIONS

Background:Facial injectable fillers have become a cornerstone of modern aesthetic medicine, offering minimally invasive solutions for facial rejuvenation, contouring, and volume restoration. Despite their widespread use and generally favorable safety profile, complications ranging from mild local reactions to severe vascular events remain a clinical concern. 

Objective:This systematic review aims to evaluate the efficacy, safety, and complication profile of facial injectable fillers, with particular emphasis on risk factors, prevention strategies, and management approaches. 

Methods:A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive literature search was performed across PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2000 and 2025. Keywords and MeSH terms included “dermal fillers,” “facial injectable fillers,” “hyaluronic acid fillers,” “aesthetic medicine,” and “complications.” Eligible studies included randomized controlled trials, cohort studies, case-control studies, and systematic reviews focusing on facial dermal fillers. Data extraction and quality assessment were conducted using standardized tools, including the Cochrane Risk of Bias Tool and the Newcastle–Ottawa Scale. 

Results:A total of 487 records were identified, of which 30 high-quality studies met the inclusion criteria. Hyaluronic acid fillers were the most commonly investigated. Immediate complications such as pain, swelling, and erythema were frequently reported but self-limiting. Early complications included infection and nodules, while late complications such as granuloma formation and filler migration were less common. Severe complications, including vascular occlusion, tissue necrosis, and vision loss, were rare but clinically significant. 

Conclusion:Facial injectable fillers are effective and generally safe when administered by trained practitioners. However, the potential for serious complications underscores the importance of anatomical knowledge, proper injection technique, and early recognition and management of adverse events.