Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases.
BACKGROUND
Purposely, cosmetic injections in orofacial tissues of various resorbable, biodegradable, or permanent fillers may be followed by development of foreign-body granulomas. The aim of this article is to contribute to the histologic identification of the filler material.


METHODS
Histologic and clinical features of 11 cases of granulomas on orofacial fillers are described.


RESULTS
Only 3/11 patients knew the nature of the injected product. Four histologic patterns were found: (i) Artecoll, (ii) Dermalive, and (iii) New-Fill granuloma, all three of the classic giant cell granuloma type, differing in respect of foreign particles; and (iv) Liquid Silicone granuloma, which featured a cystic and macrophagic type. Information was often missing or misleading, patients or practitioners being reluctant to give the details.


CONCLUSIONS
Increasing demand for orofacial tissue augmentation makes pathologists face new, and sometimes, puzzling granuloma types. Identification of the foreign product might be required for therapeutic or medico-legal reasons.
Lombardi
T
T
Laboratory of Histopathology, Division of Stomatology, Faculty of Medicine, University of Geneva, Switzerland. Tommaso.Lombardi@medecine.unige.ch
Samson
J
J
Plantier
F
F
Husson
C
C
Küffer
R
R
D000179:Acrylates / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002482:Cellulose / Q000009:adverse effects; D003094:Collagen / Q000009:adverse effects; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005145:Face / Q000473:pathology; D005260:Female; D015745:Granuloma, Foreign-Body / Q000139:chemically induced* / Q000473:pathology; D006101:Granuloma, Giant Cell / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000009:adverse effects; D020100:Hydrogels / Q000009:adverse effects; D007267:Injections; D019344:Lactic Acid / Q000009:adverse effects; D008047:Lip Diseases / Q000139:chemically induced*; D008353:Mannitol / Q000009:adverse effects; D008875:Middle Aged; D011108:Polymers / Q000009:adverse effects; D019904:Polymethyl Methacrylate / Q000009:adverse effects / Q000031:analogs & derivatives*; D019736:Prostheses and Implants / Q000009:adverse effects; D012828:Silicones / Q000009:adverse effects
D000179:Acrylates; C445359:Artecoll; C482306:Dermalive; D020100:Hydrogels; C482305:New-Fill; D011108:Polymers; D012828:Silicones; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D019344:Lactic Acid; D008353:Mannitol; D002482:Cellulose; D006820:Hyaluronic Acid; D003094:Collagen; D019904:Polymethyl Methacrylate