Delayed sclerosing granulomatous reaction to dermal filler injection of poly‐hydroxyethyl‐methacrylate suspended in hyaluronic acid: Histochemical and confocal laser scanning microscopical analysis

Abstract

Re‐absorbable dermal fillers of poly‐hydroxyethyl‐methacrylate suspended in hyaluronic acid are considered overall safe and well tolerable because of biocompatibility; nevertheless, rarely, late, or early adverse reactions may occur.

Granulomatous Reaction to Dermal Injection of Growth Factors from Umbilical Cord Blood-Derived Mesenchymal Stem Cells: A Case Report

“…Although foreign body reactions are less dramatic after resorbable implants than permanent fluidal implants, formation of late foreign body granulomatous reaction had been reported in re-absorbable dermal fillers including hyaluronic acid and poly-hydroxyethyl-methacrylate suspended in hyaluronic acid. 16,18,19 The injected volume, repetition of injections, impurities, particle size, particle surface, and hydrophilicity are reported to influence granulomas arising after dermal filler injections. 13 Although the medium injected in the current case did not contain filler materials, it caused dermal foreign body granulomatous reactions similar to those caused by dermal fillers and therefore the aforementioned factors may have played a role.…”

Complications after cosmetic periocular filler: prevention and management

“…The foreign body reaction results in prolonged inflammation that results in the formation of a nodule comprised of macrophages producing inflammatory products [48] . HA fillers reinforced with hydroxyethyl-methacrylate fragments have been associated with late-onset granuloma formation [49] . It is postulated that impurities and surface irregularities associated with formulations containing particles < 20 µm in size, are phagocytosed which propagates granuloma formation [47,[50][51][52] .…”