The impact of adverse reactions to injectable filler substances on quality of life: results from the Berlin Injectable Filler Safety (<scp>IFS</scp>) – study

Düker, Dagrun; Erdmann, R.; Hartmann, Vanessa; Nast, Alexander; Rzany, Berthold; Bachmann, Frank

doi:10.1111/jdv.13594

Cited by 13 publications

(4 citation statements)

References 22 publications

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“…Late‐onset complications include granulomatous foreign body reactions (GFBR) that have been reported after injection with almost every dermal filler but mainly with permanent ones. Such reactions are rare but can cause significant discomfort owing to their aesthetic and functional repercussions . Moreover, delayed granulomatous reactions to non‐biodegradable fillers are often refractory to treatment.…”

Section: Introductionmentioning

confidence: 99%

Management of granulomatous foreign body reaction to fillers with methotrexate

Broly

Marie

Picard³

et al. 2019

Acad Dermatol Venereol

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Background Granulomatous foreign body reactions (GFBR) have been reported after injection with almost every soft tissue fillers, more commonly with non‐biodegradable ones. Such granulomatosis is rare but can cause significant discomfort owing to their aesthetic and functional repercussions. Objective To determine whether immunomodulation with low doses of methotrexate is effective in the treatment of GFBR to filler material. Methods Clinical case series of four patients with severe, treatment‐resistant GFBR to non‐biodegradable fillers in the Department of Dermatology of Bordeaux University Hospital, Bordeaux, France, successfully treated with oral or subcutaneous methotrexate, 10–15 mg weekly during 6 months. Adverse events were monitored throughout the treatment once weekly the first month then once monthly the remaining 5 months. Results Four women with a mean age of 73.7 years (66–85 years) and nodularity of the face were included and treated up to 6 months. Histological findings were consistent with GFBR to liquid injectable silicone in 2 cases, polymethylmethacrylate in 1 case and hydroxyethylmethacrylate in the last case. The delay after injection of the filler material was from 17 to 30 years. In one patient, inflammatory lesions followed dental care. After 6 months of treatment with 10–15 mg once weekly, all patients were cleared. Three patients developed a mild hepatic cytolysis (grade 1 or 2). Methotrexate could be maintained in those 3 cases and was discontinuated after 6 months in all cases. Two patients developed recurrence of lesions, 28 and 9 months, respectively, after treatment stops, requiring reintroduction of treatment. The two other patients remained cleared after 6 months of follow‐up. Conclusion Low doses of methotrexate appear to offer a low‐risk therapeutic alternative in resistant and severe GFBR to fillers. A prospective study with long‐term follow‐up is required to confirm these preliminary observations.

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Section: Introductionmentioning

confidence: 99%

Management of granulomatous foreign body reaction to fillers with methotrexate

Broly

Marie

Picard³

et al. 2019

Acad Dermatol Venereol

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Section: Discussionmentioning

confidence: 99%

“…Although delayed-onset reactions may not be the most feared complication of treatment, they nevertheless can be disfiguring and, until their resolution, can significantly affect patients' quality of life. 38 HA fillers have traditionally been regarded as immunologically inert because of their presence in all living organisms and lack of tissue specificity. However, the degree of cross-linking technology used by manufacturers to improve longevity and modify properties of the individual HA fillers varies considerably.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Delayed-onset Inflammatory Reactions to Hyaluronic Acid Filler: An Algorithmic Approach

Funt

2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Hyaluronic acid fillers are one of the most widely used and versatile fillers worldwide. Although traditionally regarded as immunologically inert, many currently available products have been substantially modified to improve longevity and to optimize properties for specific indications. Such modifications, either alone or in combination with other factors (such as the immune status of the patient, immune-triggering events, and bacterial contamination), may lead to the development of late-onset inflammatory nodules in some patients. This article discusses the clinical presentation of late-onset adverse inflammatory reactions to hyaluronic acid injections, describes their likely triggers, and presents the author’s treatment algorithm for successful resolution.

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“…To the Editor: Injectable fillers are an increasingly common means of achieving minimally invasive facial rejuvenation. In the hands of well-trained practitioners, these compounds typically are well tolerated, effective, and have a strong safety profile 1 ; however, there have been reports of complications, including vision loss, 2 orbital infarction, 3 persistent inflammatory nodules, 4 and infection. 4,5 Paraffin, a derivative of mineral oil, currently is used in cosmetic products and medical ointments.…”

mentioning

confidence: 99%

Orbital Granuloma Formation Following Autoinjection of Paraffin Oil: Management Considerations

Cadmus

Thelin²,

Vrcek

2020

Cutis

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The impact of adverse reactions to injectable filler substances on quality of life: results from the Berlin Injectable Filler Safety (IFS) – study

Abstract: Adverse reactions to injectable filler products can have a considerable impact on the QoL, comparable to severe chronic inflammatory skin diseases such as psoriasis.

Cited by 13 publications

References 22 publications

Management of granulomatous foreign body reaction to fillers with methotrexate

Management of granulomatous foreign body reaction to fillers with methotrexate

Treatment of Delayed-onset Inflammatory Reactions to Hyaluronic Acid Filler: An Algorithmic Approach

Orbital Granuloma Formation Following Autoinjection of Paraffin Oil: Management Considerations

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