{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:03:03Z","timestamp":1779350583381,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Over the past decades, soft\u2010tissue filler injections have become an essential part of cosmetic practice worldwide. Due to the increasing demand, unlicensed practitioners venture in performing this minimally invasive procedure, injecting illegal fillers that pose serious complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the adverse effects of legal and illegal soft\u2010tissue fillers injected by licensed and unlicensed practitioners.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A 10\u2010year retrospective, descriptive, single\u2010center study conducted at the outpatient dermatology department and skin laser center at Siriraj Hospital from January 2009 to December 2019. Patients were identified as having treatment\u2010related complications. Their demographic data, clinical history, and injection history were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients with mean age of 37\u00a0years old were included in the study. Thirty\u2010five of them (87.5%) were female. Illegal soft\u2010tissue fillers were used in 28 patients (70%) and were performed by unlicensed practitioners (18 cases, 64.3%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). Adverse effects from illegal fillers (26 cases, 92.9%) developed longer than legal fillers (7 cases, 58.3%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.017). Symptoms significantly lasted longer in patients injected with illegal fillers, 10 (0.07\u2010288) weeks, as compared to patients injected with legal fillers 0.75 (0.14\u201072) weeks (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.01). Injections from illegal fillers resulted to foreign body reaction (22 cases, 78.6%) and infections (6 cases, 21.4%). Vascular complications were identified in legal fillers injections (5 cases, 41.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of adverse effects and complications from soft\u2010tissue filler injections are superior when performed by novice injectors and unlicensed practitioners using illegal fillers. Proper training of filler injections, selection of appropriate fillers, and early recognition of adverse effects are critically important to the success of treatments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.13492","type":"journal-article","created":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T18:25:32Z","timestamp":1589739932000},"page":"1580-1586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Legal vs. illegal injectable fillers: The adverse effects comparison study"],"prefix":"10.1111","volume":"19","author":[{"given":"Onjuta","family":"Chayangsu","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3926-2193","authenticated-orcid":false,"given":"Rungsima","family":"Wanitphakdeedecha","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3293-7813","authenticated-orcid":false,"given":"Penvadee","family":"Pattanaprichakul","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inneke Jane","family":"Hidajat","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"},{"name":"Department of Dermatology Faculty of Medicine Atma Jaya Catholic University of Indonesia Jakarta Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy Elleza R.","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"},{"name":"Department of Dermatology Research Institute for Tropical Medicine Manila Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woraphong","family":"Manuskiatti","sequence":"additional","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-015-0562-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.02.064"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1090820X13493638"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/14764172.2014.968584"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2013.798"},{"issue":"12","key":"e_1_2_8_7_1","first-page":"42","article-title":"Delayed\u2010type necrosis after soft\u2010tissue augmentation with hyaluronic acid","volume":"8","author":"Souza Felix Bravo B","year":"2015","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.12298"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13977"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2014.2494"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2007.00853.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1298785"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2014.29.S3.S176"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdds.2016.01.001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.14730\/aaps.2013.19.1.71"},{"key":"e_1_2_8_16_1","unstructured":"KimAE.\u201cWine Cheese and a Dash of Poison in the Forehead\u201d: exploring the evolution of the injectable filler industry and the consequent implications for regulatory action.http:\/\/www.dash.hardvard.edu. 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