title: Granulomatous facial reaction to injected cosmetic fillers--a presentation of five cases.
abstract: The use of substances to augment soft tissues as aesthetic purpose is associated with, among other undesirable effects, the appearance of foreign body granulomas. The improvements made to these substances have reduced the incidence of adverse reactions, but not eliminated them. We present five cases of foreign body reactions to three different products, dimethylpolysiloxane (silicone), bovine collagen, and polylactic acid, which were injected into the subcutaneous cellular tissue of the patients (all five were women), between two and sixteen years before the appearance of the foreign body reaction. All five presented painless, diffuse facial tumefaction, of firm, elastic consistency. The magnetic resonance image (MRI) studies showed signs of intense inflammatory reaction in the affected areas. The histology revealed the presence of foreign body granulomas with giant multi-nucleated cells. The patients were treated with systemically administered corticoids, except in one case which did not require pharmacological treatment.
authors.affiliation: Servicio de Estomatología, Hospital General Universitario Valencia, Valencia. poveda_raf@gva.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Poveda
authors.forename: José V
authors.initials: JV
authors.lastname: Bagán
authors.forename: Judith
authors.initials: J
authors.lastname: Murillo
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Jiménez
mesh_terms: D000368:Aged; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002417:Cattle; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005145:Face / Q000601:surgery*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects; D019344:Lactic Acid / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage / Q000009:adverse effects; D011282:Pregnenediones / Q000627:therapeutic use; D019736:Prostheses and Implants / Q000009:adverse effects*; D020034:Silicone Gels / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000893:Anti-Inflammatory Agents; D011091:Polyesters; D011108:Polymers; D011282:Pregnenediones; D020034:Silicone Gels; D019344:Lactic Acid; C033616:poly(lactide); D003094:Collagen; C021988:deflazacort