The Abuse of Dermal Fillers: A Clinico-Epidemiological Study of 35 Cases

Abstract

Background: Nowaday s , the use of dermal fillers for correcting signs of aging , such as wrinkles, depressions, and folds, has become increasingly popular. However, the abuse of these products can lead to disfigurements and unpredictable consequences among users. Objective: To evaluate the clinical abnormalities related to dermal fillers abuse in Iraqi people, and identify the various factors contributing to them. Methods: A total of 35 patients with different facial abnormalities due to the abuse of dermal fillers, attending our clinic in Diwaniyah, Iraq, from September 2016 to December 2017, were enrolled. A questionnaire-based analysis was used to collect clinical and sociodemographic data from patients to determine the etiological profile behind this problem. Several disfigurements and facial defects were diagnosed on clinical base. We have treated most of the situations that require intervention and treatment. Results: A total of 35 patients aged between 25 and 54 years with a sex ratio of 0.093 were enrolled in this study. Their mean age was 42 years, and the age group between 35 and 45 years was forming 85.7% of the cases. The clinical abnormalities recorded in this study include : buffy face 8 (22.8%), facial asymmetry 3 (8.5%), Mdoka fish lips like 6 (17%), periorbital redness 1 (2.8%), filler fatigue 6 (17%), bags under eyes 4 (11.4%), sizeable bulbous nose 4 (11.4%), topographical changes 2 (5.7%), and stone-like cheeks 1 (2.8%). The leading causes for the abuse of fillers were as follow s : 12 (34.28%) candidates were not compatible with the procedure, 9 (25.7%) were non-compliance with the indications of the Food and Drug Organization (FDA), 9 (25.7%) fillers were injected in the wrong place, 18 (51.4%) injections were of a larger quantity than required, and 5 (14.2%) had frequent and long-term injection. Conclusion: The use of dermal fillers for a wrong purpose can result in disfigurements rather than beautification. The commonest disfigurements are the puffy face, enlarged lips, and bags under eyes. The clinical uses of dermal fillers in Iraq need to be monitored by the health au thorities, with the assurance that these products should be sold only by a doctor’s prescription to reduce their abuse.