We would like to bring to your attention an error in an article published in the September issue of PRIME entitled ‘Reversal of a dermal filler induced facial artery occlusion’ by Patrick Treacy.

Please note there is an error in Table 1: ‘Author’s HLA reversal protocol’ on page 26. Lidocaine with adrenaline is not to be used during an acute ischaemic event.

The correct HLA reversal protocol is as follows:

  • Discontinue injection of HLA immediately
  • Massage the affected area immediately
  • Apply warm packs of gauze to area (microwave)
  • Apply nitro-paste or 10 mgs transderm-nitro patches (Novartis) for a period of up to 12 hours
  • Mix 300 units of hyalase (0.2mls) with 0.2mls (Wockhardt UK) of 2% lidocaine (Astra Zeneca)
  • Inject hyalase in 5–6 lots of 75u to occluded area with care
  • Hydrocortisone 100 mg IV stat  (if not an acute ischaemic event)
  • Dexamethsone 4 mgs daily for three days  (if not an acute ischaemic event).

We apologise for any confusion caused.

Balraj Juttla
Editor, PRIME