OROFACIAL GRANULOMAS AFTER INJECTION OF COSMETIC FILLERS: A CASE REPORT

The increasing demand for cosmetic procedures in the orofacial area results in a growing number of complications, including the development of foreign body granulomas. A 55-year-old woman presented with submucosal and subcutaneous nodules that were firm on palpation, which had arisen approximately 30 days earlier in the right buccal mucosa and in the face (cervical, submentonian, and submandibular regions). The diagnostic hypothesis was lymphoma, but after the clinical examination, the patient reported having undergone facial filling procedure 1 year before. Ultrasonography showed nodular images suggestive of reactive granulomas. Preoperative tests were requested, and incisional surgical biopsy was performed. Histologic analysis showed granulomatous reactions associated with the use of hyaluronic acid (accumulation of amorphous basophilic material) and polymethylmethacrylate (refringent material, without dye impregnation). The patient was unaware of the facial filling with polymethylmethacrylate.