Complications of dermal filler treatments – a registry-based study from Finland
DOI:
https://doi.org/10.2340/aos.v85.46216Keywords:
Complication, Finnish authority, reclamation, complaint, dermal fillersAbstract
The popularity of dermal filler treatments is increasing in the Nordic countries. In Finland, legislation does not mandate healthcare training for those performing dermal filler treatments, potentially leading to increased complications. This registry-based study aimed to characterize complaints on dermal filler treatments received by Finnish Authorities, using data from (1) Finnish Safety and Chemicals Agency (TUKES), (2) the National Supervisory Authority for Welfare and Health (Valvira), (3) the Finnish Competition and Consumer Authority (KKV), and (4) Regional State Administrative Agency (AVI). From January 1, 2017, to December 31, 2024, 19 complaints were received by KKV, unsuccessful lip filler treatments being the most common issue (59%). No life-threatening complications were reported. Most cases (56%) occurred in beauty salons, with treatments primarily performed by beauty salon employees (44%), followed by registered nurses (24%), and only 8% by medical doctors. Notably, 72% of the complications occurred in the last 3 years. The study underscores the need for regulatory oversight and advanced medical expertise in administering dermal filler treatments due to the increasing complications and the involvement of non-medical personnel. Complications may require immediate medical first aid and should be classified as procedures requiring advanced medical expertise.
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References
Facial Injectables Market Size, Share, Growth 2023 [cited 2025 Aug 18]. Available from: https://www.fortunebusinessinsights.com/industry-reports/facial-injectables-market-100603.
Surgeons ASoP. 2018 plastic surgery statistics report. Plast Surg. 2018;25:7.
Tukes. CE-merkintä. Tukes; 2023 [cited 2023 May 25]. Available from: https://tukes.fi/tuotteet-ja-palvelut/ce-merkinta#5cab3d64
Hirsch RJ, Cohen JL, Carruthers JD. Successful management of an unusual presentation of impending necrosis following a hyaluronic acid injection embolus and a proposed algorithm for management with hyaluronidase. Dermatol Surg. 2007;33(3):357–60. DOI: https://doi.org/10.1111/j.1524-4725.2007.33073.x
Lucaciu A, Samp PF, Hattingen E, Kestner RI, Davidova P, Kohnen T, et al. Sudden vision loss and neurological deficits after facial hyaluronic acid filler injection. Neurol Res Pract. 2022;4(1):40. DOI: https://doi.org/10.1186/s42466-022-00203-x
Yang Q, Lu B, Guo N, Li L, Wang Y, Ma X, et al. Fatal cerebral infarction and ophthalmic artery occlusion after nasal augmentation with hyaluronic acid – a case report and review of literature. Aesthetic Plast Surg. 2020;44(2):543–8. DOI: https://doi.org/10.1007/s00266-019-01589-x
Bowles A, Ghalili S, Ojong OB, Vasile GF, Li YM, Aguilera SB. Novel management of granuloma formation secondary to dermal filler: a multi-modality approach. J Cosmet Dermatol. 2023;22(4):1233–7. DOI: https://doi.org/10.1111/jocd.15579
Jung H. Hyaluronidase: an overview of its properties, applications, and side effects. Arch Plast Surg. 2020;47(4):297–300. DOI: https://doi.org/10.5999/aps.2020.00752
Uth CC, Elberg JJ, Zachariae C. Complications caused by injection of dermal filler in Danish patients. Eur J Plast Surg. 2016;39(6):441–8. DOI: https://doi.org/10.1007/s00238-016-1205-7
Decates TS, Sayghani F, Van Loghem JA, Velthuis PJ. The Dutch Hyacorp® filler catastrophe: new EU legislation will prevent this from happening again. Eur J Dermatol. 2022;32(5):584–8. DOI: https://doi.org/10.1684/ejd.2022.4328
Kern JA, Kollipara R, Hoss E, Boen M, Wu DC, Groff W, et al. Serious adverse events with injectable fillers: retrospective analysis of 7,659 patient outcomes. Dermatol Surg. 2022;48(5):551–5. DOI: https://doi.org/10.1097/DSS.0000000000003409
K. B-H. New aesthetic regulatory laws introduced in Sweden: Aesthetics Journal; 2021 [cited 2023 May 25]. Available from: https://aestheticsjournal.com/news/new-aesthetic-regulatory-laws-introduced-in-sweden-2.
Ortiz AE, Ahluwalia J, Song SS, Avram MM. Analysis of U.S. Food and Drug Administration data on soft-tissue filler complications. Dermatol Surg. 2020;46(7):958–61. DOI: https://doi.org/10.1097/DSS.0000000000002208
Tukes. Tietoa Tukesista 2025 [cited 2025 Oct 21]. Available from: https://tukes.fi/.
Valvira. Etusivu 2025 [cited 2025 Oct 21]. Available from: https://valvira.fi/etusivu.
Kuluttaja- ja kilpailuvirasto. Tietoa KKV:stä 2025 [cited 2025 Oct 21]. Available from: https://www.kkv.fi.
Aluehallintavirasto. Tietoa meistä 2025 [cited 2025 Oct 21]. Available from: https://avi.fi/tietoa-meista/toimintamme/valvomme.
Konsumentverket. Konsumentrapporten 2018. 2018 [cited 2025 Mar 10]. Available from: https://stpubshop.blob.core.windows.net/publikationer/konsumentrapporten-2018-konsumentverket.pdf.
Save Face, Consumer Complaints Audit Report 2017-2018[cited 2025 Aug 23]. Available from: https://www.saveface.co.uk/en/publications.
Tripathi NV, Hakimi AA, Parsa KM, Bartholomew IY, Reilly MJ, Chu E. Complications, treatment, and outcomes of self-injecting substances into the face: a systematic review. Dermatol Surg. 2024;50(1):59–61. DOI: https://doi.org/10.1097/DSS.0000000000003977
Halliday J. Tributes to woman thought first to die from ‘liquid Brazilian butt lift’ in UK 2024 [cited 2025 Aug 18]. Available from: https://www.theguardian.com/uk-news/2024/sep/26/tributes-to-woman-thought-to-be-first-to-die-from-suspected-brazilian-butt-lift-in-uk#:~:text=Tributes%20have%20been%20paid%20to,died%20early%20on%20Tuesday%20morning.
Yle. Pistoshoito pilasi kasvot 2024 [cited 2025 Aug 24]. Available from: https://yle.fi/a/74-20084962.
Nordic Council. Cosmetic surgery sector is like the wild west 2022 [cited 2025 Oct 21]. Available from: https://www.norden.org/en/news/cosmetic-surgery-sector-wild-west.
Socialstyrelsen. Estetiska behandlingar som kräver medicinsk kompetens och som kan innebära betydande hälsorisker 2018 [cited 2025 Oct 21]. Available from: https://www.socialstyrelsen.se/contentassets/15e36e072e954e6b83ca78d359020176/2018-9-21.pdf.
Review of the regulation of cosmetic interventions. 2013 [cited 2025 Aug 23]. Available from: https://assets.publishing.service.gov.uk/media/5a7a25dee5274a319e77831c/Review_of_the_Regulation_of_Cosmetic_Interventions.pdf
Rowland-Warmann MJ. Dermal fillers: lack of regulation poses a real threat to patient safety. Expert Witness Journal. 2020 Spring;61-66.
Povolotskiy R, Oleck NC, Hatzis CM, Paskhover B. Adverse events associated with aesthetic dermal fillers: a 10-year retrospective study of FDA data. Am J Cosmet Surg. 2018;35(3):143–51. DOI: https://doi.org/10.1177/0748806818757123
Chung KL, Convery C, Ejikeme I, Ghanem AM. A systematic review of the literature of delayed inflammatory reactions after hyaluronic acid filler injection to estimate the incidence of delayed type hypersensitivity reaction. Aesthet Surg J. 2019;40(5):NP286–300. DOI: https://doi.org/10.1093/asj/sjz222
Rayess HM, Svider PF, Hanba C, Patel VS, DeJoseph LM, Carron M, et al. A cross-sectional analysis of adverse events and litigation for injectable fillers. JAMA Facial Plast Surg. 2018;20(3):207–14. DOI: https://doi.org/10.1001/jamafacial.2017.1888
Soares DJ, Bowhay A, Blevins LW, Patel SM, Zuliani GF. Patterns of filler-induced facial skin ischemia: a systematic review of 243 cases and introduction of the FOEM scoring system and grading scale. Plast Reconstr Surg. 2023;151(4):592e–608e. DOI: https://doi.org/10.1097/PRS.0000000000009991
Styperek A, Bayers S, Beer M, Beer K. Nonmedical-grade injections of permanent fillers: medical and medicolegal considerations. J Clin Aesthet Dermatol. 2013;6(4):22–9.
Hermans AM, Decates T, Geysendorpher LA, Lugtenberg M. Oops I did it (again): patient experiences of complications after non-invasive cosmetic procedures. Soc Sci Med. 2024;344:116685. DOI: https://doi.org/10.1016/j.socscimed.2024.116685
Valvira. Botuliinihoidot 2021 [cited 2025 Aug 24]. Available from: https://valvira.fi/sosiaali-ja-terveydenhuolto/botuliinihoidot.
Meretsky CR, Umali JP, Schiuma AT. A systematic review and comparative analysis of botox treatment in aesthetic and therapeutic applications: advantages, disadvantages, and patient outcomes. Cureus. 2024;16(8):e67961. DOI: https://doi.org/10.7759/cureus.67961
Kapoor KM, Kapoor P, Heydenrych I, Bertossi D. Vision loss associated with hyaluronic acid fillers: a systematic review of literature. Aesthetic Plast Surg. 2020;44(3):929–44. DOI: https://doi.org/10.1007/s00266-019-01562-8
Berberi A, Hjeij B, Aad G, Aoun G. Infected facial tissue fillers caused by dental infection. Case Rep Dent. 2021;2021:8661995. DOI: https://doi.org/10.1155/2021/8661995
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Copyright (c) 2026 Vilma Koivisto, Jaana Rautava, Hanna K. Laine
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Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
