Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Evaluation and management of facial granuloma caused by various injection materials

  • Jang, Jin Woo (Department of Plastic Surgery, Kyung Hee University Hospital) ;
  • Kang, Sang Yoon (Department of Plastic Surgery, Kyung Hee University Hospital)
  • Received : 2020.11.24
  • Accepted : 2021.02.15
  • Published : 2021.02.20
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Abstract

Background: Various substances are currently being used for cosmetic or postsurgical reconstruction reasons. Injecting of various materials into the face may provoke inflammatory or granulomatous reactions, infection and tissue necrosis. Among these reactions are foreign body granulomas. This study aims to describe the clinical characteristics of and therapeutic approaches used in patients with facial foreign body granulomas caused by the injection of various substances. Methods: From 2007 to 2020, a total of 64 patients visited our hospital due to inflammatory signs, palpable masses or surface irregularities. We reviewed patient characteristics, type of injected material, medical history and treatment outcomes. The treatment results were scored with patient satisfaction and statistical analysis of the treatment period was performed. Results: Most patients underwent conservative treatment followed by surgical treatment because of persistent symptoms; one patient did not require surgery. All patients reported good treatment results and satisfaction. The earlier the surgical treatment was performed, the shorter the treatment period and the higher patient satisfaction scoring. Conclusion: Granulomatous changes to the face are an emerging concern in various cosmetic procedures and surgeries, including fillers, silicone implants and autologous fat injections. Our findings strongly suggest that patient symptoms require accurate diagnosis and surgical treatment.

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References

  1. Ohashi M, Chiba A, Nakai H, Fukuda E, Higuchi T. serial injections of cryopreserved fat at -196℃ for tissue rejuvenation, scar treatment, and volume augmentation. Plast Reconstr Surg Glob Open 2018;6:e1742. https://doi.org/10.1097/GOX.0000000000001742
  2. Engelman DE, Bloom B, Goldberg DJ. Dermal fillers: complications and informed consent. J Cosmet Laser Ther 2005;7:29-32. https://doi.org/10.1080/147641700510037716
  3. Williams GT, Williams WJ. Granulomatous inflammation: a review. J Clin Pathol 1983;36:723-33. https://doi.org/10.1136/jcp.36.7.723
  4. Lemperle G, Gauthier-Hazan N, Wolters M, Eisemann-Klein M, Zimmermann U, Duffy DM. Foreign body granulomas after all injectable dermal fillers: part 1. Possible causes. Plast Reconstr Surg 2009;123:1842-63. https://doi.org/10.1097/PRS.0b013e31818236d7
  5. Lowe NJ, Maxwell CA, Patnaik R. Adverse reactions to dermal fillers: review. Dermatol Surg 2005;31(11 Pt 2):1616-25.
  6. Jones DH, Carruthers A, Orentreich D, Brody HJ, Lai MY, Azen S, et al. Highly purified 1000-cSt silicone oil for treatment of human immunodeficiency virus-associated facial lipoatrophy: an open pilot trial. Dermatol Surg 2004;30:1279-86. https://doi.org/10.1097/00042728-200410000-00001
  7. Park KG, Dhong ES, Namgoong S, Han JK, Han SK, Kim WK. Atypical facial filler granuloma: comparative histologic analysis with paraffinoma. Arch Craniofac Surg 2016;17:169-72. https://doi.org/10.7181/acfs.2016.17.3.169
  8. Lee JM, Kim YJ. Foreign body granulomas after the use of dermal fillers: pathophysiology, clinical appearance, histologic features, and treatment. Arch Plast Surg 2015;42:232-9. https://doi.org/10.5999/aps.2015.42.2.232
  9. Kim CY. Overview of filler: compositions, effects, rheological consideration. J Korean Soc Aesthetic Plast Surg 2011;17:1-5.
  10. Hong WT, Kim J, Kim SW. Minimizing tissue damage due to filler injection with systemic hyperbaric oxygen therapy. Arch Craniofac Surg 2019;20:246-50. https://doi.org/10.7181/acfs.2019.00059
  11. Coleman SR. Structural fat grafts: the ideal filler? Clin Plast Surg 2001;28:111-9. https://doi.org/10.1016/S0094-1298(20)32343-9
  12. Hong KY. Fat grafts enriched with adipose-derived stem cells. Arch Craniofac Surg 2020;21:211-8. https://doi.org/10.7181/acfs.2020.00325
  13. Gutowski KA; ASPS Fat Graft Task Force. Current applications and safety of autologous fat grafts: a report of the ASPS fat graft task force. Plast Reconstr Surg 2009;124:272-80. https://doi.org/10.1097/PRS.0b013e3181a09506
  14. Guerrerosantos J, Gonzalez-Mendoza A, Masmela Y, Gonzalez MA, Deos M, Diaz P. Long-term survival of free fat grafts in muscle: an experimental study in rats. Aesthetic Plast Surg 1996;20:403-8. https://doi.org/10.1007/BF02390315
  15. Yang HJ, Kang SY. Comparisons between fresh and cryopreserved fat injections in facial lipofilling. Arch Craniofac Surg 2020;21:15-21. https://doi.org/10.7181/acfs.2019.00612
  16. Requena L, Requena C, Christensen L, Zimmermann US, Kutzner H, Cerroni L. Adverse reactions to injectable soft tissue fillers. J Am Acad Dermatol 2011;64:1-34. https://doi.org/10.1016/j.jaad.2010.02.064
  17. Doh GH, Bahk S, Hong KY, Lim SA, Han KM, Eo SR. Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates. Arch Craniofac Surg 2018;19:143-7. https://doi.org/10.7181/acfs.2018.19.2.143
  18. Ko EY, Sung HM, Cho G, Park YK, Tak KS, Suh IS, et al. Usefulness of high-resolution ultrasonography after foreign body injection on aesthetic plastic surgery. J Korean Soc Plast Reconstr Surg 2010;37:385-90.
  19. Park TH, Seo SW, Kim JK, Chang CH. The efficacy of perilesional surgical approach for foreign body granuloma. Plast Reconstr Surg 2011;127:121e-123e. https://doi.org/10.1097/PRS.0b013e318213a15c
  20. Choi M, Son KM, Choi WY, Cheon JS. Usefulness of the Versajet hydrosurgery system for the removal of foreign body granuloma. Arch Plast Surg 2017;44:352-3. https://doi.org/10.5999/aps.2017.44.4.352
  21. Park JW. Ocular swelling after forehead fat graft. Arch Aesthetic Plast Surg 2014;20:85-91. https://doi.org/10.14730/aaps.2014.20.2.85