Granulomas and nongranulomatous nodules after filler injection: Different complications require different treatments

Article Article scientifique Article Granulomas and nongranulomatous nodules after filler injection: Different complications require different treatments eng 2020 author Modarressi Ghavami Seyed Ali 105647 author Nizet Christophe 918662 author Lombardi Tommaso 22312 10.1016/j.bjps.2020.08.012 32928687 1748-6815 Dermal fillers are widely used for facial rejuvenation and reconstruction and present fewer risks than surgical approaches. Nevertheless, several complications may occur, including nodule formation. A nodule is a clinical sign corresponding to different etiologies, such as overcorrection, infection, allergic reaction, or granuloma. However, their treatment represents a diagnostic challenge. We present a retrospective review of 26 consecutive patients who underwent a biopsy for facial nodule formation more than 3 months after filler injections, to determine the diagnosis of the nodule and type of filler used. All patients were women (mean age, 57.8 years). Some patients suffered from different localizations: lip, 14 cases; nasolabial folds, 6; cheeks, 5; infraorbital region, 5; the glabella, 2; the temporal region, 1; and chin, 1 case. Only 5 (19.2%) patients knew the type of filler used, and in another 4 cases, the injector was able to provide some information. In 65.4% of cases, the filler type was unknown. Histopathological analysis revealed a "granulomatous" nodule in 30 sites and a "non-granulomatous" nodule in 4 cases. Concerning the type of filler, 5 different histopathological patterns were found. Our results demonstrate that a clinical history and histopathological analysis whether to confirm or not to confirm the diagnosis of granuloma and to identify the type of filler are essential tools to achieve an accurate diagnosis of the problem-oriented treatment of nodules after dermal filler injections. We propose an algorithm for the management of nodules after filler injection. Complication Dermal fillers Granuloma Histopathology Nodule. Dewey 617 57 Département de chirurgie 222 false 238 Groupe Lombardi Tommaso (médecine dentaire) 313 72 Groupe Pittet Cuenod Brigitte (chirurgie plastique et reconstructive) 96 Journal of Plastic, Reconstructive & Aesthetic Surgery 72aa5b63-4dbb-4143-967a-6536495eb056 Article (Accepted version) Public main-2.pdf 3939186 application/pdf CC BY-NC-ND openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Granulomas and nongranulomatous nodules after filler injection: Different complications require different treatments	Journal of Plastic, Reconstructive & Aesthetic Surgery			2020	373	359

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Nizet, Christophe