Management of Permanent Filler Complications Using Deep-Plane Facelift and Temporoparietal Fascial Flap Reconstruction: A Retrospective Study

Abstract Background Permanent fillers can lead to long-term complications, including granulomas, infections, and migration. Their removal often causes significant facial defects, posing challenges in reconstructive surgery. Objectives The authors of this study aim to evaluate the clinical outcomes of deep-plane facelifts combined with temporoparietal fascial flap (TPFF) reconstruction in managing complications and restoring aesthetics following permanent filler removal. Methods This retrospective study included 160 patients who underwent deep-plane facelifts with permanent filler removal and TPFF reconstruction between 2014 and 2022. Those with unrealistic expectations, BMI >30, a recent infection (≤3 months), or severe malar edema were excluded. The average follow-up period was 16 months (range, 6-68 months). Results Of 160 patients (149 females, 11 males; mean age 48 ± 8.4 years), 131 (82%) completed follow-up. The complication rate was 22%, including transient swelling and bruising (15%), minor infections (4%), and hematomas (3%). Psychological outcomes improved significantly, with increased self-esteem and social interaction scores and reduced anxiety and depression levels. Hospital stays averaged 32 h (range, 24-48 h). Conclusions TPFF reconstruction during deep-plane facelifts is a reliable approach for addressing complications and defects following permanent filler removal. This technique provides reliable reconstruction and improved outcomes, with promising long-term stability. Further research is warranted to refine these methods and optimize patient care. Level of Evidence: 4 (Therapeutic)