Abstract
Background
Periorbital lipogranuloma following autologous fat injection into the forehead for cosmetic facial augmentation is a recently described adverse outcome. Patients have typically been treated with surgical excision. This study evaluates the clinical characteristics of periorbital lipogranulomas, and the non-surgical treatment outcomes of these patients.
Methods
This is a noncomparative, interventional case series. A retrospective analysis of clinical data and radiographic images was performed of patients with periorbital lipogranuloma following autologous fat injection. Objective treatment outcomes after intralesional triamcinolone injection and/or oral prednisolone were evaluated by measuring the size of the lipogranulomas pre- and post-treatment. Cosmetic outcomes were also assessed by the subjective satisfaction at the last visit.
Results
Twenty-seven patients were identified with periorbital lipogranuloma following facial autologous fat injection. All patients were female, the mean age was 40 ± 10 years, and 19 patients received cryopreserved fat. Twenty-one patients underwent non-surgical corticosteroid treatment. ‘Resolution’ was achieved in 15 patients (71 %), and ‘Partial Resolution’ was achieved in 5 patients (24 %). One patient (5 %) who took oral prednisone alone showed ‘No Response’. Cosmetic outcomes were classified as ‘Very Satisfied’ in 16 patients (76 %), ‘Satisfied’ in 4 patients (19 %), and ‘Dissatisfied’ in 1 patient (5 %) after corticosteroid treatment.
Conclusion
Periorbital lipogranuloma following autologous fat injection may be diagnosed by history, physical exam, and orbital imaging. Non-surgical corticosteroid treatments showed a good response with few adverse effects and should be considered as a first line of treatment of periorbital granulomas prior to conducting surgical excision.
Level of Evidence IV
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References
Lemperle G, Rullan PP, Gauthier-Hazan N (2006) Avoiding and treating dermal filler complications. Plast Reconstr Surg 118:92s–107s
Locke MB, de Chalain TM (2008) Current practice in autologous fat transplantation: suggested clinical guidelines based on a review of recent literature. Ann Plast Surg 60:98–102
Feinendegen DL, Baumgartner RW, Vuadens P, Schroth G, Mattle HP, Regli F, Tschopp H (1998) Autologous fat injection for soft tissue augmentation in the face: a safe procedure? Aesthet Plast Surg 22:163–167
Thaunat O, Thaler F, Loirat P, Decroix JP, Boulin A (2004) Cerebral fat embolism induced by facial fat injection. Plast Reconstr Surg 113:2235–2236
Sa HS, Woo KI, Suh YL, Kim YD (2011) Periorbital lipogranuloma: a previously unknown complication of autologous fat injections for facial augmentation. Br J Ophthalmol 95:1259–1263
Paik JS, Cho WK, Park GS, Yang SW (2013) Eyelid-associated complications after autogenous fat injection for cosmetic forehead augmentation. BMC Ophthalmol 13:32
Ryeung Park Y, Choi JA, La Yoon T (2013) Periorbital lipogranuloma after cryopreserved autologous fat injection at forehead: unexpected complication of a popular cosmetic procedure. Can J Ophthalmol 48:e166–168
Carlos-Fabuel L, Marzal-Gamarra C, Marti-Alamo S, Mancheno-Franch A (2012) Foreign body granulomatous reactions to cosmetic fillers. J Clin Exp Dent 4:e244–247
Lemperle G, Gauthier-Hazan N (2009) Foreign body granulomas after all injectable dermal fillers: part 2. Treatment options. Plast Reconstr Surg 123:1864–1873
Ben Simon GJ, Huang L, Nakra T, Schwarcz RM, McCann JD, Goldberg RA (2005) Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective? Ophthalmology 112:913–917
Wong MY, Yau GS, Lee JW, Yuen CY (2014) Intralesional triamcinolone acetonide injection for the treatment of primary chalazions. Int Ophthalmol 34:1049–1053
Conejo-Mir JS, Sanz Guirado S, Angel Munoz M (2006) Adverse granulomatous reaction to Artecoll treated by intralesional 5-fluorouracil and triamcinolone injections. Dermatol Surg 32:1079–1081 discussion 1082
Kim JH, Ahn DK, Jeong HS, Suh IS (2014) Treatment algorithm of complications after filler injection: based on wound healing process. J Korean Med Sci 29:S176–s182
Sclafani AP, Fagien S (2009) Treatment of injectable soft tissue filler complications. Dermatol Surg 35(Suppl 2):1672–1680
Kim KJ, Lee HW, Lee MW, Choi JH, Moon KC, Koh JK (2004) Artecoll granuloma: a rare adverse reaction induced by microimplant in the treatment of neck wrinkles. Dermatol Surg 30:545–547
Ben Simon GJ, Rosen N, Rosner M, Spierer A (2011) Intralesional triamcinolone acetonide injection versus incision and curettage for primary chalazia: a prospective, randomized study. Am J Ophthalmol 151(714–718):e711
Goawalla A, Lee V (2007) A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses. Clin Exp Ophthalmol 35:706–712
Carroll LA, Hanasono MM, Mikulec AA, Kita M, Koch RJ (2002) Triamcinolone stimulates bFGF production and inhibits TGF-beta1 production by human dermal fibroblasts. Dermatol Surg 28:704–709
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Seo, J.W., Sa, HS. Periorbital Lipogranuloma Following Facial Autologous Fat Injections: Non-surgical Treatment. Aesth Plast Surg 39, 946–952 (2015). https://doi.org/10.1007/s00266-015-0554-0
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DOI: https://doi.org/10.1007/s00266-015-0554-0