Foreign Body Granuloma After Filler

A foreign body granuloma is a chronic inflammatory reaction of the body to a material it cannot clear. Immune cells gather around the particles of the product and form an organized nodule. In HOF, it is a late and rare complication of fillers, but important to know because its treatment differs from that of other nodules.

How does a granuloma usually present?

The typical picture is the appearance, months or years after the injection, of firm nodules, sometimes reddened, that may grow in size and show up in several treated spots at the same time. Sometimes there is a trigger, such as an infection, a vaccine or another procedure on the face, but it is not always identified.

It can happen with any filler, including hyaluronic acid, and is more associated with long-lasting and permanent products. The differential diagnosis includes product accumulation, infection and biofilm, and may require imaging or a biopsy.

How is it treated?

Management depends on the product and the clinical picture. When the material is hyaluronic acid, hyaluronidase may be part of the treatment. With collagen biostimulators and permanent products, management usually involves medication and, in some cases, surgical removal. Treatment is led by the qualified professional, often together with other specialties, according to the rules of their professional council.

Recording the product, the lot, the area and the date of each injection in the patient record helps a great deal when a late complication appears. The general topic is covered in safety and complications.

In Harmy

Harmy's History keeps the sessions for each patient with date and photos, which complements the patient record when reconstructing what was injected.

Also called: filler granuloma, granulomatous reaction.