Persistent fillers: different management of undesirable outcome after HA injections in the periocular area. Comparison of two cases.
Author: Rebeca Roses Saiz
Base Hospital / Institution: Consorci Sanitari Integral, Barcelona. IMO Grupo Miranza Barcelona.
ePoster presentation
Abstract ID: 24-454
Purpose
To report successful treatment of persistent post-hyaluronic acid recurrent eyelid edema (PHAREE) which had not responded to previous hyluronidase injections. To report anatomopathological findings in periocular tissues affected with persistent hyaluronic acid (HA) fillers.
Methods
Two patients with a past history of multiple HA injections in the mid-face and periocular area presented with recurrent eyelid edema which was firstly diagnosed as preseptal celulitis. Both of them described nodular, painless, mobile lesions far from the site of injection associated with eyelid edema. Radiological findings (CT, MRI) were not conclusive. Echo findings were not compatible with HA echogenicity.
Results
One patient responded to a combination of treatments (multiple hyaluronidase injections, oral antibiotics) whereas the other one required an excisional diagnostic biopsy. Histological findings demonstrated a degeneration of the SOOF infiltrated with AH. Both patients reported a resolution of PHAREE signs/symptoms with no adverse effects or recurrence.
Conclusion
Hyaluronic acid filler injections are commonly administered for periocular and facial volume restoration. Among their complications, post-injection recurrent eyelid edema and lymph-granulomatous reaction have been described. Further research on pathophysiologic mechanisms and a standardised treatment protocol is desirable, as the number of patients affected with this condition is likely to increase in our practice.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alejandra | Herranz Cabarcos | Consorci Sanitari Integral, Barcelona. IMO Grupo Miranza Barcelona. |
| Isabel | Mayo Pampin | Consorci Sanitari Integral, Barcelona. IMO Grupo Miranza Barcelona. |
