edema

Edema is swelling caused by the accumulation of fluids in the interstitial and intracellular spaces of the body. We can distinguish it into two types:

INFLAMMATORY (also called EXUDATE, occurs when the leakage of liquid from the vessels is caused by an increase in the permeability of the capillary walls: the liquid leaves the vessel and accumulates in the tissues. This process always occurs due to inflammation.
NON-INFLAMMATORY (or transudate, it is not caused by inflammation, but is determined by alteration of the hemodynamic forces caused, for example, by an obstruction of the lymphatic vessels which are no longer able to drain liquid causing LYMPHOEDEMA)

The factors that influence the extent of an edema are:

Product and technique used
Area affected by the injection (generally the most subject areas are the lips and the periorbital region)
Predisposing factors of the patient

Symptomatology

The affected area is swollen, painful and, in some cases, may even be warm to the touch.

Treatment

Treatment depends on the severity of the edema:

MILD:

Cold packs
Manual drainage several times a day
Galenic anti-inflammatory (Bromelain 300 mg/day for a maximum of 3 days)

MODERATE:

Non-steroidal anti-inflammatory drugs (NSAIDs) – NB It is important to use stomach protectors to reduce the gastrointestinal damage associated with NSAID use

SERIOUS:

Corticosteroid drugs + gastric protector: the dosage (in mg/kg/day) will depend on the symptoms and clinical condition, of the duration based on the clinical course. 1.

Other forms of edema

Angioedema

A very important point that must be underlined is that after a medical/aesthetic treatment, some swelling is physiological and transient. However, this swelling should not be confused with angioedema (antibody-mediated edema). This situation occurs when the patient develops hypersensitivity to the ingredients contained in the product used during treatment with the consequent production of IgE antibodies (type I hypersensitivity reaction).
Angioedema usually occurs within hours of exposure to the substance but episodes lasting more than 6 weeks may also occur. The therapeutic approach in these cases is performed “step by step” based on the response obtained from the person. Edema must be controlled with minimal doses of steroids.

Another type of late-onset edema involves hypersensitivity reactions (characterized by induration, erythema and edema) which usually occur 1 day after the injection but have been reported to appear several weeks after the procedure and persist for many months. Antihistamines are not effective in these cases but the most effective approach has been found to be the removal of the

Malar Edema

Malar edema consists of swelling of the malar area (precise point: from the lateral side of the eye, descend perpendicularly by 1.5 cm – that point is the affected area). It is mainly due to an accumulation of fluids in the subcutaneous tissue (some patients can manifest this lymphatic impairment through malar edema even without having performed any type of treatment).
Filler injection can cause edema either when the product is placed too superficially (thereby preventing lymphatic drainage) or by direct pressure on the lymphatic vessels when injection volumes are too large.

Precautions

It is very important not to sunbathe the affected area and to avoid physical activity until complete resolution.

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