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Overall, this study shows that patients have satisfactory
results with this procedure. About 52% of patients were
very satisfied, 24% of patients were satisfied, 10% of patients
were moderately satisfied, and 14% were unsatisfied.
Furthermore, we have to underline that 8 patients (19%) had
no need to repeat the treatment, 34 patients (81%) repeated
the treatment once, and 23 patients (54.7%) repeated the
treatment 2 times or more.
Fortunately only three complications occurred: one local
infection resolved administering antibiotic and two lumps
treated injecting hyaluronidase. In our study, we had no
serious side effects unlike what happened to Chaput et al.
that described a severe case of cellulitis. [11]
Our experience conducted over 42 cases suggests that
Figure 5: Outline of saphenous vein anatomy the use of macrofillers, if compared with major surgery
like the insertion of the silicon prosthesis, offers a
persistent local symptoms (erythema, edema, induration, better balance between efficacy and safety for good
pruritus, and hyperpigmentation) aesthetic results, because this technique is less invasive
• Late complications include: infection, filler migration, and also because of the low rate of side effects. These
delayed hypersensitivity reaction, foreign‑body granuloma, are the reasons why this technique should be taken in
and scarring. [7‑10]
consideration especially in the case of remodeling and/or
small augmentation of calves.
A case report in 2012 showed cellulitis of calf 5 days after
injection of 150 mL of HA subcutaneously. This patient REFERENCES
was treated with empiric antibiotic therapy (amoxicillin
and clavulanic acid 1 g twice a day) with improvement of 1. Gómez‑de la Fuente E, Alvarez‑Fernández JG, Pinedo F, Naz E, Gamo R,
symptoms within 72 h. This case shows that a serious Vicente‑Martín FJ, Lopez‑Estebaranz JL. Cutaneous adverse reaction to
[11]
complication can be resolved easily. Bio‑Alcamid implant. Actas Dermosifiliogr 2007;98:271-5.
2. Klein AW, Elson ML. The history of substances for soft tissue augmentation.
In this study, complications were seen in three cases. One Dermatol Surg 2000;26:1096-105.
patient developed local infection that resolved with oral 3. Hedén P, Sellman G, von Wachenfeldt M, Olenius M, Fagrell D. Body shaping
antibiotics (amoxicillin and clavulanic acid). and volume restoration: the role of hyaluronic acid. Aesthetic Plast Surg
2009;33:274-82.
Furthermore, we had two cases of lumps treated injecting 4. McCleave MJ. Is breast augmentation using hyaluronic acid safe? Aesthetic
hyaluronidase locally with consequent total reabsorption Plast Surg 2010;34:65-8.
of the filler and correction of the defects. 5. Broder KW, Cohen SR. An overview of permanent and semipermanent
fillers. Plast Reconstr Surg 2006;118 (3 Suppl):7S-14.
Contraindications 6. Fumihiko I, Toshiya H, Kazuaki S. Hyaluronic acid breast augmentation. Jpn
J Plast Reconstr Surg 2006;49:1335-41.
Avoid injection of fillers in areas with poor perfusion or 7. Tezel A, Fredrickson GH. The science of hyaluronic acid dermal fillers.
in areas of infection or inflammation. J Cosmet Laser Ther 2008;10:35-42.
8. Lupo MP. Hyaluronic acid fillers in facial rejuvenation. Semin Cutan Med Surg
Do not use macrofillers in areas that were previously 2006;25:122-6.
treated with liquid silicone or other permanent fillers 9. Andre P. Hyaluronic acid and its use as a “rejuvenation” agent in cosmetic
because it could lead to inflammation or infection of the dermatology. Semin Cutan Med Surg 2004;23:218-22.
implants. 10. Winslow CP. The management of dermal filler complications. Facial Plast
Surg 2009;25:124-8.
It is contraindicated to use filler if patient has 11. Chaput B, Eburdery H, Crouzet C, Grolleau JL, Chavoin JP, Garrido I.
Macrolane : a severe case of calf cellulitis after modeling injection. Ann Chir
®
hypersensitivity to any components of the filler. Plast Esthet 2012;57:83‑6.
DISCUSSION How to cite this article: Rosset L, Goisis M. Hyaluronic acid in
calves defects correction. Plast Aesthet Res 2014;1:62-4.
In patients who consider their calves as excessively tight, Source of Support: Nil, Conflict of Interest: None declared.
calf augmentation can be attained using HA fillers. Received: 28-03-2014; Accepted: 09-07-2014

64 Plast Aesthet Res || Vol 1 || Issue 2 || Sep 2014