Evidence map›Paper›PMID 41947479›Full record

ArticleJournal of cosmetic dermatology2026

Advanced Regenerative Drainage and Immunomodulatory Protocol for Dermal Filler-Induced Skin Necrosis: A Prospective Clinical Case Series.

Macarena Olivares, Diego Araya, Eloisa Forero, María José Benoit, Victor Mercado

Abstract read
In one paragraph

Article in Journal of cosmetic dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Macarena OlivaresAesthetic Department, Instituto Chileno de Rejuvenecimiento y Optimización de Medicina Estética, Santiago, Chile.ORCID https://orcid.org/0009-0006-2914-0914
Diego ArayaAesthetic Department, Instituto Chileno de Rejuvenecimiento y Optimización de Medicina Estética, Santiago, Chile.
Eloisa ForeroAesthetic Department, Instituto Chileno de Rejuvenecimiento y Optimización de Medicina Estética, Santiago, Chile.
María José BenoitAesthetic Department, Instituto Chileno de Rejuvenecimiento y Optimización de Medicina Estética, Santiago, Chile.
Victor MercadoAesthetic Department, Instituto Chileno de Rejuvenecimiento y Optimización de Medicina Estética, Santiago, Chile.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe widespread use of hyaluronic acid (HA) dermal fillers has been accompanied by an increase in vascular complications, including ischemia and cutaneous necrosis. Although uncommon, filler-induced vascular compromise represents one of the most severe adverse events in aesthetic medicine and requires immediate recognition and intervention. Conventional management strategies based primarily on hyaluronidase may be insufficient in advanced ischemic stages, where inflammatory amplification and microvascular dysfunction contribute to progressive tissue injury.

objectiveTo evaluate the clinical outcomes of the Advanced Regenerative and Immunomodulatory Drainage Protocol (ARDIP), a multimodal therapeutic approach designed to restore tissue perfusion, reduce inflammatory burden, and promote regenerative healing in patients with facial skin necrosis secondary to hyaluronic acid dermal fillers.

methodsA prospective, non-randomized interventional case series was conducted including 20 patients presenting with vascular occlusion (VO) and cutaneous necrosis following hyaluronic acid injections. Lesions were classified according to a staged ischemic progression system (VO Stages III-Vb). All patients were treated using the ARDIP, which integrates high-dose hyaluronidase reperfusion, topical fibrinolytic therapy, controlled mechanical drainage through micropuncture techniques, and stage-adjusted systemic and regenerative adjuvant therapies. Clinical outcomes were assessed through standardized photographic documentation, healing time, and the Global Aesthetic Improvement Scale (GAIS).

resultsAll patients completed treatment and follow-up. Complete tissue recovery without visible scarring was achieved in 95% of cases. Mean healing time was 15 ± 2.6 days, with faster recovery in early stages. The mean GAIS score was 1.05 ± 0.22, indicating exceptional aesthetic improvement. No systemic or local adverse events were observed.

conclusionsARDIP appears to be a safe and effective multimodal strategy for the management of filler-induced skin necrosis, addressing both mechanical vascular obstruction and the associated inflammatory cascade.

Indexed as

Cosmetic TechniquesDermal FillersDrainageHyaluronic AcidIschemiaSkinAdultCombined Modality TherapyFaceFemaleFibrinolytic AgentsHumansHyaluronoglucosaminidaseMaleMiddle AgedNecrosisDermal FillersFibrinolytic AgentsHyaluronic AcidHyaluronoglucosaminidaseARDIPhyaluronic acidhyaluronidasemultimodal treatmenttissue necrosisvascular complication

Identifiers

PMID41947479
PMCPMC13058399

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.