Temporary granulomatous inflammation following collagen implantation

Heise, H; Zimmermann, R.; Heise, P.

doi:10.1054/jcms.2001.0222

Cited by 14 publications

(12 citation statements)

References 7 publications

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“…Consequently, the reactivity of the immune system in varying percentages has been described for all materials, resulting in a lymphocyte and often histiocytic reaction with granuloma formation. [3][4][5][6][7][8] In the quest for a nontoxic and nonallergenic implant with a supposedly ideal combination of both resorbability and collagen formation, PLA has been used. It is a synthetic and resorbable molecule obtained after the polymerization of lactic acid monomers.…”

Section: Discussionmentioning

confidence: 99%

NewFill for Skin Augmentation: A New Filler or Failure?

Beljaards

Roos

BRUINS

2006

Dermatologic Surgery

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Section: Discussionmentioning

confidence: 99%

NewFill for Skin Augmentation: A New Filler or Failure?

Beljaards

Roos

BRUINS

2006

Dermatologic Surgery

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“…The induration usually resolves spontaneously in less than 1 year. 29,38,39,45 In contrast, granuloma-producing agents must persist within cells for a long time. Macrophages are assumed to be "memory cells" even if they move away once degradation is complete.…”

Section: Cystic Granulomamentioning

confidence: 99%

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lemperle

Gauthier-Hazan

Wolters

et al. 2009

Plastic and Reconstructive Surgery

216

243

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Summary Genuine granuloma formation following implantation of injectable dermal fillers is a rare complication, with incidences ranging from one in 100 patients (1 percent) to one in 5000 (0.02 percent). Foreign body granulomas occur several months to years after injection at all implantation sites at the same time. Without treatment, they may grow to the size of beans, remain virtually unchanged for some years, and then resolve spontaneously. Three clinical and histologic types of foreign body granulomas can be distinguished: 1. Cystic granulomas (synonyms: inflammatory, palisading, collagenolytic): these are caused mainly by injected biological gels such as collagens and hyaluronic acids. Their clinical signs are fluctuation (sterile abscess), extreme redness, and induration. Cystic granulomas are small and superficial, occur within the first year, and disappear spontaneously within another year. They are surrounded by a significant number of giant cells. 2. Edematous granulomas (synonym: lipogranuloma): these are caused by artificial fluids such as silicone and polyacrylamides. They appear suddenly years after injection with extensive swelling and are surrounded and infiltrated by mononuclear and inflammatory cells. 3. Sclerosing granulomas (synonyms: sarcoidal and xanthelasmic): these are caused by particulate injectables composed of polymethylmethacrylate, polylactic acid, hydroxyethylmethacrylate, calcium-hydroxylapatite, or dextran microspheres. Sclerosing granulomas occur generally 6 months to 3 years after implantation and are visible, often bluish confined nodules. Histologically, the implant is infiltrated by many macrophages and giant cells, fibroblasts, and collagen fibers but few inflammatory cells. Permanent implants are not characterized by a higher rate of foreign body granuloma per se than temporary implants; however, their clinical appearance is more pronounced and their persistence longer if not treated adequately. (Plast.

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“…Complications with collagen gel have also been considered a result of delayed hypersensitivity or type‐4 reactions to bovine collagen, although prior skin testing was negative 22,23 . One such lesion was presented as “abscess/nodule formation as a hypersensitivity reaction despite double‐negative skin testing” by Matarasso 22 …”

Section: Abnormal Long‐term Effectsmentioning

confidence: 99%

Host Tissue Interaction, Fate, and Risks of Degradable and Nondegradable Gel Fillers

Christensen

2009

Dermatologic Surgery

135

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Complications following homogenous hydrogels are caused by infection with bacteria, which have been inserted into the gel during injection. If not treated with relevant antibiotics (but instead steroids or large doses of NSAIDs) the bacteria form a biofilm, which gives rise to a low-grade chronic infection that is resistant to antibiotics. Complications following particulated gels and silicone oil are not known, but bacteria in a biofilm and/or endotoxins released by these is a possibility which deserves further investigations, primarily by using the fluorescence in situ hybridization (FISH) technique.

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Temporary granulomatous inflammation following collagen implantation

Cited by 14 publications

References 7 publications

NewFill for Skin Augmentation: A New Filler or Failure?

NewFill for Skin Augmentation: A New Filler or Failure?

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Host Tissue Interaction, Fate, and Risks of Degradable and Nondegradable Gel Fillers

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