A Retrospective Review of the Safety and Efficacy of Low-dose Triamcinolone Mixed with Hyaluronic Acid Fillers to Reduce Post-injection Infraorbital Swelling

Robyn Siperstein; Jose Raul Montes; AnnMari Speranza

A Retrospective Review of the Safety and Efficacy of Low-dose Triamcinolone Mixed with Hyaluronic Acid Fillers to Reduce Post-injection Infraorbital Swelling

J Clin Aesthet Dermatol. 2022 Apr;15(4):13-19.

Authors

Robyn Siperstein^{1

2

3}, Jose Raul Montes^{1

2

3}, AnnMari Speranza^{1

2

3}

Affiliations

¹ Dr. Siperstein is with the University of Miami in Miami, Florida.
² Dr. Montes is with the Ophthalmology Department at the University of Puerto Rico in San Juan, Puerto Rico.
³ Dr. Speranza is with the University of Tampa in Tampa, Florida.

PMID: 35465031
PMCID: PMC9017664

Abstract

Objective: This retrospective review assesses the efficacy and safety of low-dose triamcinolone (1mg/cc) added to hyaluronic acid fillers to decrease swelling after infraorbital injection.

Methods: This retrospective analysis includes 447 patients who underwent 706 infraorbital hyaluronic acid filler treatments from April 2013 to March 2020 by a single injector. Short-term post-procedural swelling (≤2 weeks) was assessed through follow-up phone calls, which were documented in patient charts. The effect of triamcinolone, filler type, volume, and patient characteristics on the rate of post-procedure swelling were analyzed.

Results: Swelling after infraorbital hyaluronic acid filler occurred in over half of the patients (51%, 103/202), but significantly decreased (23%, 29/124) when 1mg/cc of triamcinolone was mixed with the filler (x2[1, N=326]=24.296, p<0.00001). The incidence of swelling was directly correlated with the amount of hyaluronic acid filler injected (37% ≤ 0.55cc, 51% 0.56-1cc, and 60% >1cc) [x2[1, N=95]=3.9231, p=.048]. There was no significant difference in patient age, sex, Fitzpatrick skin type, or history of allergies on incidence of post-procedure swelling. Adverse events were limited to expected injection-site reactions, and there were no reports of hypopigmentation or atrophy from the addition of triamcinolone.

Limitations: This is a retrospective study that used patient reporting for short-term post procedure swelling.

Conclusion: This is the first retrospective study showing the safety and efficacy of a novel technique adding low-dose triamcinolone (1mg/cc) to hyaluronic acid filler to reduce post-procedure swelling within the first few weeks following infraorbital injection. Additionally, using lower volumes is also effective at reducing post-procedure swelling. Larger, randomized, controlled trials are needed to support our findings.

Keywords: Infraorbital filler; edema; filler complications; hyaluronic acid filler; post-procedure swelling; swelling; swelling prevention; tear trough filler; triamcinolone.

Publication types

Review