Buccal reaction to silicone cosmetic filler.
BACKGROUND
Administering injections of dermal fillers has become a popular office procedure that is performed to restore facial volume, augment facial volume or both. Injectable silicone is a nonbiodegradable filler that was introduced 40 years ago. Adverse reactions can develop from its long-term presence in the body.


METHODS
The authors evaluated a 45-year-old woman who nine years previously had received bilateral silicone cosmetic filler injections in the malar regions of her face. Two years and again five years later, she developed painless buccal swellings on the right side of her face, but the condition regressed spontaneously. When a third episode of right buccal swelling persisted, she sought care. Therapy involving the use of antibiotic agents and steroids resolved the patient's reaction to the silicone, but the pathophysiology of the reaction has not been delineated clearly.


CONCLUSIONS
Dental practitioners may see orofacial inflammatory swellings initiated by a reaction to silicone. Differentiating it from facial cellulitis is essential. Practitioners should base their diagnoses of orofacial inflammatory swellings on patients' history of receiving injectable cosmetic filler.
Mandel
Louis
L
Salivary Gland Center, and Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, 630 W. 168th St., New York, NY 10032, USA.
Addison
Samuel
S
Clark
Matthew
M
D001672:Biocompatible Materials / Q000009:adverse effects*; D002481:Cellulitis / Q000209:etiology* / Q000473:pathology; D002610:Cheek; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004890:Erythema / Q000209:etiology; D005148:Facial Dermatoses / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008264:Macrophages / Q000473:pathology; D008875:Middle Aged; D020034:Silicone Gels / Q000009:adverse effects*; D040521:Subcutaneous Tissue / Q000473:pathology
D001672:Biocompatible Materials; D020034:Silicone Gels