title: Adverse reactions to injectable soft tissue fillers: memorable cases and their clinico-pathological overview.
abstract: BACKGROUND
  Filler injection is a minimally invasive procedure widely used for soft tissue augmentation. Although the safety profile is favorable, adverse events can occur, especially after illegal filler injection.
  
  
  OBJECTIVE
  The authors present memorable cases of filler complications and review their clinico-pathological features and treatment strategies.
  
  
  METHODS
  This is a retrospective, single-center case series. The authors identified eight patients with significant complications following filler injection. A medical record review was performed for clinical history, histopathological studies, and treatment.
  
  
  RESULTS
  Six female and two male subjects presented with significant filler complications. The time interval between filler injection and the development of a complication varied greatly among cases (immediately afterwards to 14 years following filler injection). Four of the patients received illegal filler injection where the injected material was either unknown (25%) or was told as paraffin (12.5%) or Vaseline(®) (12.5%). Hyaluronic acid fillers were used in two patients (25%) and the rest were injected with porcine atelocollagen (12.5%) and polyacrylamide hydrogel (12.5%). The complications were classified as an allergic reaction (25%), filler material migration (12.5%), injection necrosis + embolism (25%), and foreign body granuloma (37.5%), based on their clinico-pathological features and were treated accordingly.
  
  
  CONCLUSIONS
  Adverse effects are not uncommon following filler injection. Physicians should be aware of the potential side effects, recognize their presentations, and understand how to manage them.
authors.affiliation: Mein Skin Clinic , Seoul , Republic of Korea.
authors.forename: Soo-Keun
authors.initials: SK
authors.lastname: Lee
authors.forename: So Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Cho
authors.forename: Jeong Deuk
authors.initials: JD
authors.lastname: Lee
authors.forename: Hei Sung
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D015745:Granuloma, Foreign-Body / Q000209:etiology; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects; D006967:Hypersensitivity / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D010232:Paraffin / Q000008:administration & dosage / Q000009:adverse effects; D010577:Petrolatum / Q000008:administration & dosage / Q000009:adverse effects; D012060:Rejuvenation; D012189:Retrospective Studies; D015595:Skin Aging; D013552:Swine
chemical_list: D000067548:Dermal Fillers; C059821:atelocollagen; D010232:Paraffin; D010577:Petrolatum; D006820:Hyaluronic Acid; D003094:Collagen
keywords: adverse reactions; memorable cases; soft tissue fillers