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Case Reports
. 2020 May 26;7(1):68-72.
doi: 10.1080/23320885.2020.1769481.

An unusual and delayed complication of hyaluronic acid filler injection: a case report

Narges Horriat  1 , Tina R Woods  2 , Abelardo Medina  1
Affiliations
Case Reports

An unusual and delayed complication of hyaluronic acid filler injection: a case report

Narges Horriat et al. Case Reports Plast Surg Hand Surg. .

Abstract

48-year-old female with facial granulomatous nodules and fungal/bacterial infection after hyaluronic acid injection. She underwent anti-fungal/antibacterial therapy and local excision. The proposed mechanisms include inflammatory foreign body reaction and pathogen contamination. Providers must exercise caution with the use of facial fillers and demonstrate expertise in avoiding and managing potential complications.

Keywords: Filler; adverse reaction; hyaluronic acid; nasolabial folds.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
One month after the hyaluronic acid filler injection, patient developed a facial hypersensitivity reaction consisting in facial edema, erythema, itchiness and mild fever.
Figure 2.
Figure 2.
A. Verrucous ulcerative skin lesions on nasolabial folds, marionette lines and glabellar region (not shown). B. Detail of the lesions on the left side of the face. C and D. Arrowheads show the abnormal heterogeneous enhancing soft tissue extending along the lateral left maxilla (1.6 cm AP by 1.0 cm transverse by 2.6 cm craniocaudal dimensions).
Figure 3.
Figure 3.
A and B. Intraoperative images showing the communication between nearby lesions and extension up to the infraorbital rim. C and D. Postoperative wounds that healed with regular dressing by secondary intention.
Figure 4.
Figure 4.
A. Intraoperative image showing the specimens from the left nasolabial fold and left marionette line. B. Hematoxylin-eosin stain showing lipogranulomas with granulomatous inflammation within the connective tissue stroma (20× magnification).
Figure 5.
Figure 5.
Eight months after surgical excision of verrucous skin lesions. Patient showed no signs of ongoing infection and wounds are well healed. Deep scarring in the nasolabial folds has made the folds more prominent.
See this image and copyright information in PMC

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