Evidence map›Paper›PMID 40809419›Full record

ArticleFrontiers in medicine2025

A new protocol (THIS and FAT) for the treatment of filler-induced vascular occlusion: a case series.

Shahriar Nazari, Nabil Fakih-Gomez, Nima Hadadian, Foroohe Bayat, Behnam Bohlouli, Cristina Muñoz-Gonzalez, Mohammad Reza Pourani

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Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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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

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Shahriar NazariDepartment of ENT and Head and Neck Surgery, BMI Hospital, Tehran, Iran.
Nabil Fakih-GomezDepartment of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon.
Nima HadadianSchool of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Foroohe BayatSchool of Medicine, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran.
Behnam BohlouliOral and Maxillofacial Surgery, University of Toronto, Toronto, ON, Canada.
Cristina Muñoz-GonzalezDepartment of Facial Plastic and Cranio-Maxillo-Facial Surgery, Fakih Hospital, Khaizaran, Lebanon.
Mohammad Reza PouraniSkin Research Center, Shohada-e Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Hyaluronic acid (HA) fillers are generally safe; however, the most significant complication is vascular occlusion. Several therapeutic protocols have been proposed for managing ischemia. De Lorenzi introduced the HDPH protocol, which uses a minimum of 500 IU of hyaluronidase (HYAL) per ischemic area. Materials and methods: This case series study evaluates the efficacy of a novel protocol, "THIS and FAT," for managing ischemia resulting from filler-induced vascular occlusion (FIVO). The protocol builds on elements from previous approaches while introducing combination therapies specifically tailored to address ischemia. The therapeutic regimen includes T: botulinum toxin type A (BTX-A), H: high-dose HYAL, I: injectable platelet-rich fibrin (iPRF), S: serum platelet-rich fibrin (sPRF), a: aspirin and antibiotics, n: nanofat, d: debridement and dermabrasion, and F: fat membrane application. Results: A total of 25 eligible patients, including 20 women and 5 men with a mean age of 32.36 ± 6.71 years, were included. The THIS and FAT protocol involved the injection of BTX-A and HYAL, with mean doses of 50.68 ± 60.79 Units and 5970.0 ± 2791.65 IU, respectively. Additionally, iPRF and sPRF were applied to the ischemic wound surface. Debridement was performed for ischemia classified as stage three or higher. Notably, 92% of patients treated with the THIS and FAT protocol showed complete improvement without scar formation. Conclusion: "THIS and FAT" Protocol for managing ischemia following FIVO shows promising outcomes. Additionally, wound management with fat membrane, iPRF injections, sPRF dressing, and nanofat application resulted in favorable outcomes in this case series.

Indexed as

fat membranehyaluronic acidhyaluronidaseischemiananofat membranenecrosis

Identifiers

PMID40809419
PMCPMC12343624

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