Immediate and delayed complications in orofacial harmonization

Abstract

Objective: To comparatively analyze immediate or early and delayed complications associated with dermal fillers, botulinum toxin type A, and lifting threads used in orofacial harmonization. Literature review: Temporal classification supports clinical reasoning but should be interpreted together with the product used, the probable mechanism, and the progression of signs. With fillers, the main findings include self-limiting local reactions, vascular occlusion, visual impairment, nodules, recurrent delayed edema, granulomas, and changes related to material positioning. Botulinum toxin-related events are mainly associated with dose, diffusion, and neuromuscular action, whereas thread-related complications also involve mechanical factors linked to insertion, traction, and fixation. Final considerations: Distinguishing expected reactions from more severe complications requires integrated clinical assessment, adequate documentation, follow-up, and emergency preparedness throughout the post-procedure period. The main contribution of this review is to organize clinical decision-making according to the relationship between chronology, mechanism, product, and warning signs, supporting individualized management and safer patient care.