title: Foreign body reaction to facial dermal fillers: case report.
abstract: We present a patient who developed a delayed granulomatous reaction after injections of hyaluronic acid and bovine collagen glutaraldehyde that were introduced 6 and 4 years, respectively, previous to her present visit. She was a healthy 65-year-old woman, who was seen in November 2010 at the Columbia University Salivary Gland Center with a tentative diagnosis of a left buccal facial swelling caused by a "blocked parotid duct." The swelling was only slightly painful and had developed 1 month previously after a periodontal surgical procedure that involved the maxillary left quadrant. Questioning indicated that the swelling did not fluctuate in size nor had it changed its configuration since its sudden inception 2 days after the periodontal surgery. Visibly, the swelling was slightly erythematous. Palpation caused only mild discomfort and revealed the swelling to be quite firm in tone. The lesion involved the left facial buccal tissues, with its extraoral center corresponding to the intraoral location of the parotid duct orifice. The swelling was diffuse, with no definitive outline. It measured approximately 3 cm horizontally and 3.5 cm in height. Posteriorly, palpation of the left parotid gland revealed the gland to be painless, normal in tone, and not swollen. No swelling or discomfort was evident on the right side. No trismus was present.
authors.affiliation: Oral and Maxillofacial Surgery Resident, New York-Presbyterian Hospital, Columbia Campus, New York, NY, USA.
authors.forename: Whitney
authors.initials: W
authors.lastname: Florin
authors.forename: Louis
authors.initials: L
authors.lastname: Mandel
mesh_terms: D000368:Aged; D000818:Animals; D002417:Cattle; D003094:Collagen / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003432:Cross-Linking Reagents / Q000009:adverse effects*; D062109:Dermatologic Surgical Procedures; D003937:Diagnosis, Differential; D005148:Facial Dermatoses / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D005549:Foreign-Body Reaction / Q000139:chemically induced*; D005976:Glutaral / Q000009:adverse effects*; D015745:Granuloma, Foreign-Body / Q000139:chemically induced; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects*; D010305:Parotid Diseases / Q000175:diagnosis
chemical_list: D003432:Cross-Linking Reagents; D006820:Hyaluronic Acid; D003094:Collagen; D005976:Glutaral