Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases

Abstract

Background: Purposely, cosmetic injections in orofacial tissues of various resorbable, biodegradable, or permanent fillers may be followed by development of foreign‐body granulomas. The aim of this article is to contribute to the histologic identification of the filler material. Methods: Histologic and clinical features of 11 cases of granulomas on orofacial fillers are described. Results: Only 3/11 patients knew the nature of the injected product. Four histologic patterns were found: (i) Artecoll, (ii) Dermalive, and (iii) New‐Fill granuloma, all three of the classic giant cell granuloma type, differing in respect of foreign particles; and (iv) Liquid Silicone granuloma, which featured a cystic and macrophagic type. Information was often missing or misleading, patients or practitioners being reluctant to give the details. Conclusion: Increasing demand for orofacial tissue augmentation makes pathologists face new, and sometimes, puzzling granuloma types. Identification of the foreign product might be required for therapeutic or medico‐legal reasons.