BACKGROUND:Delayed complications associated with hyaluronic acid (HA) fillers are a concern in aesthetic medicine. However, clinical strategies for mitigation remain inconsistent, and guidelines often make recommendations that may lack the support of robust evidence. To address this gap, a multidisciplinary expert safety council convened to develop evidence-based recommendations aimed at reducing the delayed complication risk of soft-tissue augmentation with fillers, noting which recommendations are uncertain due to lack of evidence. METHODS:A structured advisory board meeting was held with 8 United States-based experts in aesthetic injectables. Discussions were informed by a comprehensive literature review, pre-meeting surveys, and real-time polling, with consensus statements refined following the meeting. RESULTS:The council reached full consensus on 8 key recommendations across 4 risk factor categories: patient history, product characteristics, procedural technique, and postprocedure care. A consistent theme across all categories was the lack of robust clinical evidence supporting many current guidelines, underscoring the need for more evidence-based recommendations. CONCLUSION:This expert consensus highlights the need for evidence-informed approaches to HA filler safety. While definitive data remain limited, the panel offers a practical framework for minimizing delayed complications and identifying priorities for future research. .
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