Letter: Foreign Body Reaction to Hyaluronic Acid Filler Injection: In Search of an Etiology

Mamelak, Adam J.; Katz, Tracy M.; Goldberg, Leonard Harry; Graves, Jeffery J.; Kaye, Valda N.; Friedman, Paul M.

doi:10.1111/j.1524-4725.2009.01350.x

Cited by 21 publications

(31 citation statements)

References 13 publications

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“…1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Before 1999, the reported rate of delayed reactions to HA fillers was 0.07%. The introduction of highly purified products decreased the incidence of such side effects to 0.02%, 1 which is now the accepted safety threshold for HA-based products.…”

Section: Discussionmentioning

confidence: 99%

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Artzi

Loizides²,

Verner

et al. 2016

Dermatologic Surgery

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Section: Discussionmentioning

confidence: 99%

Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel

Artzi

Loizides²,

Verner

et al. 2016

Dermatologic Surgery

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“…The authors suggested an infectious origin responsible for the hypersensitivity reaction. 24 There was one report of a biopsy-proven foreign body granulomatous reaction after calcium hydroxylapatite injection, but immunologic testing was not performed. 25 The rate of palpable nodules after use of poly-L-lactic acid have been reported at 3.2% 26 and granulomatous reactions up to 12% 27 ; however, biopsyconfirmed granulomatous reactions were reported by Vleggar at 1.1%.…”

Section: Resultsmentioning

confidence: 99%

Soft Tissue Fillers and Biofilms

Dayan¹,

Arkins

Brindise

2011

Facial plast Surg

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The purpose of this study was to review the clinical course of reported hypersensitivity reactions associated with use of soft tissue fillers and the response of these reactions to treatment. In this comprehensive literature review, we identified ~40 published reports that together reported numerous adverse reactions associated with use of nonpermanent soft tissue fillers; however, very few of these reactions were consistent with type I immediate or type IV delayed hypersensitivity reactions. Based on their clinical course and response to treatment, most reported hypersensitivity reactions are likely due to an infectious process. Although there are no confirmed reports of biofilm reactions associated with nonpermanent fillers, the possibility of bacterial contaminants should be considered in acute or chronic inflammatory reactions associated with use of nonpermanent soft tissue fillers. Early treatment with antibiotics is recommended.

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“…Many theories exist as to the aetiology of foreign‐body reaction to HA filler injections. A hypersensitivity reaction to a tiny amount of protein contaminants within the filler or bacterial contamination at the time of filler injection have been suggested as potential aetiologies for the granulomatous response . However, the nodule in this case represents a very rare local complication of HA filler injection.…”

mentioning

confidence: 82%