Efficacy and Safety of Extracorporeal Shock Wave Therapy and 1064 nm Nd: YAG Laser in Managing Nodules and Edema Following Cosmetic Injections: A Case Series and Systematic Literature Review

BACKGROUND: Advances in injectable techniques and materials have driven rapid growth in the esthetic injection market, with more products showing excellent efficacy and safety. Nevertheless, adverse reactions continue to be reported, among which chronic inflammatory nodules and swelling are particularly challenging to manage. Despite many etiological theories and diagnostic consensus, clinical treatment remains complex and difficult. Novel approaches are continually being explored. Among them, energy-based devices (EBDs) therapy has shown promising potential and clinical value, as evidenced by some clinical reports. OBJECTIVE: Evaluate the efficacy and safety of extracorporeal shock wave therapy (ESWT) and 1064 nm Nd:YAG laser in managing adverse reactions such as nodules and swelling following cosmetic injections. METHODS: This study demonstrates four treatment cases combining different energy-based devices, documenting therapeutic protocols and efficacy. A systematic literature review is incorporated to evaluate EBDs applications and therapeutic value. RESULTS: All of the four cases recovered from nodules or swelling without side effects by receiving ESWT and 1064 nm Nd:YAG laser, and the existing reports have demonstrated preliminary clinical experience with EBDs, showing promising efficacy and potential for broader applications in this field. CONCLUSION: ESWT and 1064 nm Nd:YAG laser have demonstrated effectiveness in treating post-injection nodules and swelling, achieving high patient satisfaction with minimal side effects. Future studies should focus on elucidating their mechanisms and standardizing treatment protocols. Other energy-based devices (EBDs) may have potential in this field, which requires further clinical verification.