title: Diagnosis and management of dermal filler complications in the perioral region.
abstract: BACKGROUND
  Lip augmentation with injectable materials is a popular aesthetic procedure. When complications occur, patients often ignore which material was implanted, thus making subsequent treatments difficult. This study aims to present the diagnosis and management of dermal filler complications in the perioral region.
  
  
  METHODS
  The Medical charts of 26 patients with filler complications in the oral region were reviewed. All patients were submitted to High Frequency Ultrasound, often complemented by Magnetic Resonance Imaging (MRI) and White Blood Cell Scintigraphy, to evaluate filler characteristics and complication types. Antibiotic, corticosteroid or surgical treatment was therefore planned.
  
  
  RESULTS
  Imaging always identified dermal fillers in the oral region, distinguishing among infections, fibrosis, granulomatous inflammation and product migration. Nine patients received surgery, ten received medical treatments, six received both, and one refused treatment. Eighty percent of the patients presented an improvement after three- year follow-up.
  
  
  CONCLUSIONS
  Complications of oral region fillers are similar in clinical presentation but differ in etiology, therefore necessitating different clinical approaches. Imaging techniques add useful information for treatment planning.
authors.affiliation: Plastic Surgery Unit, NESMOS Department, S Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome , Rome , Italy.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Grippaudo
authors.forename: Marco
authors.initials: M
authors.lastname: Di Girolamo
authors.forename: Mauro
authors.initials: M
authors.lastname: Mattei
authors.forename: Eugenio
authors.initials: E
authors.lastname: Pucci
authors.forename: Cristina
authors.initials: C
authors.lastname: Grippaudo
mesh_terms: D000305:Adrenal Cortex Hormones; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007962:Leukocytes; D008046:Lip; D008047:Lip Diseases / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000009:adverse effects*; D011877:Radionuclide Imaging; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D011108:Polymers
keywords: complication; fillers; imaging; surgery