BMJ Case Reports 2013; doi:10.1136/bcr-2012-007141
  • Unexpected outcome (positive or negative) including adverse drug reactions

Complications of facial fillers: resource implications for NHS hospitals

  1. Jonathan Collier
  1. Craniofacial Orbito Palpebral Service, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK
  1. Correspondence to Dr Nadine Hachach-Haram, nadine.haram{at}


Facial rejuvenation seeks to reverse the negative sequelae of multiple factors but most importantly of genetic predisposition, sun damage and smoking. With the advent of the so-called ‘non-surgical’ techniques, and perhaps fuelled by these austere times, volumetric facial augmentation using dermal fillers has soared in popularity among both patients and practitioners. However, legislation has yet to keep pace with the change in clinical practices leaving patients poorly informed and with no protection against unscrupulous suppliers and unregulated practitioners. When things go wrong, patients often turn to the National Health Service (NHS) to rectify both the acute and chronic sequelae resulting in potentially difficult ethical and resource implications. Here, we report one of an increasing number of cases presenting to our NHS craniofacial service with acute filler-related complications.

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