Personalized treatment of patients with complications after nasolacrimal groove contouring

Abstract

Contouring of the nasolacrimal groove area is becoming an increasingly popular procedure due to the rapid onset of a pronounced aesthetic result, however, in recent years, there has been an increase in the pool of complications both in the early and late post-injection recovery period. Meanwhile, there are no differentiated approaches to the choice of physiotherapy techniques and their combinations depending on the genetic profile of the patient and the clinical and functional picture of the complication. Objective: to develop and evaluate the use of personalized physiotherapy in patients with complications after the injection of fillers based on stabilized hyaluronic acid, taking into account patients’ genetic predisposition. Material and methods. The study analyzed the data of 47 patients, aged 35.7±10.2, with a diagnosis of L57.4 — cutis laxa senilis, who received late complications (local edema, filler contouring, sensitivity change at the filler injection site) after the injection of a filler based on stabilized hyaluronic acid in the nasolacrimal groovearea. All patients underwent genetic testing on the Cosmetology panel before the start of treatment. There were 3 groups that received longidase diadinamophoresis, injection carboxytherapy of the nasolacrimal groove area, or a combination of the above techniques. Result. When using a combined course of longidase diadinamophoresis and injection carboxytherapy, there was a significant decrease in such clinical manifestations as contouring, local edema and neuropathy; the psycho-emotional state of patients stabilized. In addition, the therapeutic complex significantly accelerated the biodegradation of the filler and had a restructuring effect on the skin of the nasolacrimal furrow, reducing the thickness of the dermis, increasing the dermis density coefficient, and accelerating the biodegradation of the superficially injected preparation, compared to other study groups. Conclusion. The personalized combined use of the technique, including a course of longidase diadinamophoresis and injection carboxytherapy for the correction of complications of nasolacrimal groove contouring with fillers based on stabilized hyaluronic acid in the form of local edema, neuropathy, and filler contouring, is a highly effective treatment method, which is confirmed by the relief of clinical symptoms, acceleration of biodegradation of the drug, and improvement of the quality of life of patients.