Dermal fillers can cause mild or severe tissue reactions after injection, such as bleeding from the needle eye, mild swelling, skin redness or bruising, etc., which generally disappear on their own without treatment. Some adverse reactions may persist for several days and do not subside, or may require appropriate treatment if the symptoms are severe, such as infection, localized elevation, nodules, or displacement of the injected material. Although most of the adverse reactions have appropriate management measures, it is important to pay attention to the diagnosis to avoid secondary trauma and disfigurement or life-threatening injuries caused by incorrect treatment. The following is a detailed explanation of each of the common adverse reactions: Tindal phenomenon Tindal phenomenon occurs when a light blue reaction occurs at the injection site due to the injection of too much soft tissue filler in a thin area of the skin. Physically this phenomenon is caused by the scattering of light by particles in the colloid. Treatment is topical application of lysozyme-degradable material or waiting for the injected material to dissipate on its own. Nodules, bumps This is most often seen when the injected material is over-injected locally or when the injection level is too shallow. In individual cases, position or movement can also cause the distribution of injectables to change, resulting in nodules or bumps. For example, when the supine position is changed to standing position, injectables that were originally dispersed may collect in a lower position due to gravity and form bumps, and injectables in the muscle may also be squeezed into a mass when the muscle contracts and form a hard solution or bump. Treatment measures can be performed with lysozyme injections for degradable materials, while surgical removal is required for non-degradable materials or unidentified injections. Preoperative MRI is required to differentiate from the granuloma described below. Displacement of the injected material A single large injection or a concentrated injection into the lumen may result in displacement of the injected material with gravity and active compression. Of course, in some cases, the injected material is not regular enough and may invade the surrounding tissues, which may also cause displacement of the injected material, such as the higher incidence of displacement of materials such as Omnidene. Once the injection is displaced, lysis or surgical removal of the injected material can be considered. Infection Injection infections are mostly caused by microbial invasion such as bacteria or viruses, with local manifestations of redness, swelling, heat and pain. Most of these infections are caused by a lack of asepsis or strict sterilization during the injection process, but in many cases, they are also related to a decrease in the immune system of the patient. Once detected, it needs to be treated actively with systemic antibiotics and local drainage if necessary, or hospitalization for anti-inflammatory treatment and continuous drainage by incision if the symptoms are severe. Inflammatory granuloma Granuloma is an immune reaction that can be caused by a delayed allergic reaction due to the patient’s physiology or the impurity of the injected material. The clinical manifestation is a nodule or mass at the injection site, with or without hyperpigmentation and inflammatory reaction. It needs to be carefully differentiated from the aforementioned masses produced by displacement of the injected material or excessive injection volume. In general, sarcoidosis does not respond well to surgery and is relatively sensitive to hormonal injections, but the condition is more likely to recur and requires multiple treatments. Some people advocate surgical removal of the injected material first to reduce subsequent foreign body irritation, while others oppose surgery, believing that it may promote granuloma proliferation, and recommend drug therapy alone. The author believes that the specific treatment needs to be considered in the context of the patient’s condition, depending on the main cause of granuloma production. In conclusion, micropigmentation does not mean that the consequences are minor. Any unprofessional operation and inattention to detail may cause the failure of the surgery, and the cost is not minor once the failure occurs. Please be sure to recognize the regularity of the institution and the regularity of the drug when you undergo the surgery. For patients who have already developed surgical complications or have been injected with illegal or unknown injectables, please go to a regular hospital as soon as possible to see an experienced doctor to avoid secondary injuries.