What Are my Risks of Exposure to Bloodborne Pathogens from a Used Syringe of Restylane?

hat are my risks of exposure to Bloodborne pathogens from a used syringe of Restylane? Isn't this malpractice? My employer did this without my knowledge or consent. After a severe outbreak of herpes I became suspicious of the treatment I received. I confronted my employer and she admitted using 2 partial syringes that had been used on 2 other people. She didn't respond when I asked if she changed the needles. Please help!!

Doctor Answers 10

Re-using Dermal Filler Syringes

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I am shocked to hear a story like this – unbelievable!

Restylane and Perlane (as well as all other pre-packaged sterile injectable fillers) are single use only. This means that the syringe is to be used one time only for a single patient treatment. If the entire syringe is not used during that treatment session the syringe should be disposed. Re-using left over product, even in the same patient, is not recommended to reduce the risk of bacterial infection. Re-using left over product on a different patient is certainly not recommended due to the risk of disease transmission, namely blood-borne pathogens such as hepatitis C, hepatitis B, and HIV.

I can’t believe any healthcare provider would re-use a needle, and this represents serious malpractice. You may want to discuss your situation with a lawyer, and such practice should be reported to the licensing medical board as well as to OSHA. This is no different than any other ‘hollow core needle stick’ injury that occurs in the medical work place, other than that yours was potentially done with prior knowledge if the needle was re-used. You should contact employee health at your facility, or your personal physician, to document your exposure, to have appropriate testing, and to discuss the need for any potential treatment.

With respect to the herpes infection you experienced, herpes out breaks may occur following use o injectable fillers. Pre-treatment with an anti-viral, such as Valacyclovir, may reduce the risk herpes re-activation if you desire additional treatments in the future.

Sorry to hear about your experience, and best of luck to you.

Restylane castoffs not for use.

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what on earth is she thinking? throw out the old syringes. there is nothing that is free in this world.  if it was done without your knowledge, you need representation.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

This is a very serious issue.

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No needle or syringe should ever be reused on another person.  For the same reason, partially used syringes of filler or BOTOX should never be stored for later use.  Unused material must be disposed of in a sharps container to avoid the risk of contamination or cross-contamination.  Hepatitis and AIDS has been transmitted in this fashion.  I am not an attorney, however, you might want to consider contacting a labor lawyer regrading your situation.  I do not believe that it would be very common for herpes to be transmitted in this fashion so I can't comment on this as a means of getting herpes.  There are a number of agencies that govern this type of behavior by your employer including OSHA, the corresponding state version of OSHA, and the medical board that licenses your doctor.  They will all be very troubled by these allegations.  If you cannot get your doctor to change their behavior, reporting them will protect others form what is a very dangerous practice.  Because of the seriousness of your allegations, you might do well to discuss the situation with a lawyer before reporting your allegations.  I would also encourage you to discuss your possible needle exposure with your personal physician so that you can get the appropriate testing and medical care to reduce the risk of contracting a serious blood borne viral illness.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restylane - What Are my Risks of Exposure to Bloodborne Pathogens from a Used Syringe of Restylane?

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The primary concern for you is your health, and you need to do a few things to make sure you're okay.

The syringes are intended to be for single-patient use, and at one time.  It is not advisable to share syringes between patients for any reason, and that's even with the assumption that new needles are used.  There is simply too much risk of contamination.  More and more medications are being packaged for single use for this reason.

Although it is comforting to believe that there was no contamination and to let it go at that, I would advise that you contact your physician (your primary care physician) immediately, explain what happened and what the concerns are and, most likely, undergo a series of tests to try to determine if you have any new or unexplained diseases or conditions.  (Even if you do you may not be able to prove how you got it/them, but that's a separate issue).  You may need to go for additional or repeated testing.

Needless to say, it is hoped that everything will be okay and that you will not have to undergo anything more than a few blood tests; ie, that it will be nothing more than a scare and an annoyance.

Just as needless to say, I would advise strongly against anyone undergoing such treatments (the sharing of a syringe between two patients) or performing such treatments.

I hope that this helps, and good luck,

Dr. E

Single use of Restylane

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The syringes are for one patient use only. Unfortunately, there are doctors or lay injectors who will share. However, proving that yout infection came from that syringe will be difficult. Report it to your state medical board.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Syringes of Fillers are to be Used Only Once

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I am sorry to hear of your unfortunate situation.  It will be difficult to prove whether your herpes outbreak was caused by the reuse of another patient's Restylane, but this should never be done.  Your employer (is she a doctor?) should not be injecting patients if these are her standards.

James Bartels, MD
Manchester Facial Plastic Surgeon

Using the Same Restylane on 2 Different Patients?

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Hi Mykr.  If it's not malpractice then it is very, very bad medicine.  You should get an answer to your last question before taking the next step.  It is important to know whether or not needles were change to answer your first question.  If they were not, then you may well have been exposed to any medical conditions that the other patients may have had.

As you can see from the other practitioner's responses, it is hard to imagine a physician doing this to one of his employees and you may need to think about finding other employment as this person does not have very good ethics.  You may also need to check into getting a lawyer involved if you feel that your employer is not being honest with you.  

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Any physican would change the needle after injection

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I would suggest that you have a open discussion with your physician. your doctor should not reuse partially used filler. It is not good medicine. The concern is contamination and transmitting blood born infections.

Restylane syringes are single use only

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Restylane syringes, as well as any other fillers that come in pre-packaged sealed, sterile syringes are for one time use and only in one patient. Re-using any left over product from a syringe that has been used to inject a patient is not recommended by the filler companies and generally considered to not be safe for many reasons. I suggest you have a frank discussion with your employer (injecting physician) at a time when you can sit down and not be rushed (not in between patients) and find out exactly what really happened with your treatment and then consider the proper course of action as outlined by Dr. Steinsapir.


Restylane Syringes are Single Use

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It is not uncommon to see oral herpes ("cold sores") after Restylane injection, especially to the lips.  This is considered a reactivation of latent herpes virus.  If your herpes outbreak was oral, then this is probably the explanation. 

Although I have heard of some doctors dividing a syringe of Restylane between two patients (after switching needles), this is not recommended and is not standard of care.  I would not "split" a syringe of Restylane between two patients.

It is hard to believe that any doctor or injector would reuse a needle that had been used on another patient.  This is an extremely dangerous practice fraught with risk of disease transmission.  If your employer indeed reused a needle on you, it is your obligation to take action against her as suggested by Dr. Steinsapir, both for your protection and for that of other unsuspecting patients.

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.