title: Periorbital Lipogranuloma Following Facial Autologous Fat Injections: Non-surgical Treatment.
abstract: BACKGROUND
  Periorbital lipogranuloma following autologous fat injection into the forehead for cosmetic facial augmentation is a recently described adverse outcome. Patients have typically been treated with surgical excision. This study evaluates the clinical characteristics of periorbital lipogranulomas, and the non-surgical treatment outcomes of these patients.
  
  
  METHODS
  This is a noncomparative, interventional case series. A retrospective analysis of clinical data and radiographic images was performed of patients with periorbital lipogranuloma following autologous fat injection. Objective treatment outcomes after intralesional triamcinolone injection and/or oral prednisolone were evaluated by measuring the size of the lipogranulomas pre- and post-treatment. Cosmetic outcomes were also assessed by the subjective satisfaction at the last visit.
  
  
  RESULTS
  Twenty-seven patients were identified with periorbital lipogranuloma following facial autologous fat injection. All patients were female, the mean age was 40 ± 10 years, and 19 patients received cryopreserved fat. Twenty-one patients underwent non-surgical corticosteroid treatment. 'Resolution' was achieved in 15 patients (71%), and 'Partial Resolution' was achieved in 5 patients (24%). One patient (5%) who took oral prednisone alone showed 'No Response'. Cosmetic outcomes were classified as 'Very Satisfied' in 16 patients (76%), 'Satisfied' in 4 patients (19%), and 'Dissatisfied' in 1 patient (5%) after corticosteroid treatment.
  
  
  CONCLUSIONS
  Periorbital lipogranuloma following autologous fat injection may be diagnosed by history, physical exam, and orbital imaging. Non-surgical corticosteroid treatments showed a good response with few adverse effects and should be considered as a first line of treatment of periorbital granulomas prior to conducting surgical excision.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
authors: Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Pungnap-2-dong, Songpa-gu, Seoul, 138-736, Korea.
authors: Ji Won
authors: JW
authors: Seo
authors: Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1 Pungnap-2-dong, Songpa-gu, Seoul, 138-736, Korea. lineblue@hanmail.net.
authors: Ho-Seok
authors: HS
authors: Sa
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D064592:Autografts; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005145:Face; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006099:Granuloma / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D009915:Orbit; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D011241:Prednisone
keywords: Corticosteroid treatment; Facial autologous fat injection; Non-surgical treatment; Periorbital lipogranuloma