Foreign body granulomatous reactions to cosmetic fillers

INTRODUCTION The use of different facial cosmetic fillers has increased in recent years. The introduction of apparently inert substances in the epidermis can give rise to foreign body granulomatous reactions. Objetives: A literature review is made of the foreign body granulomatous reactions to cosmetic fillers. MATERIAL AND METHODS A PubMed-Medline search was made using the following keywords: "granulomatous reactions", "foreign body reactions", "esthetic fillers", "cosmetic fillers". The search was limited to articles published in English and Spanish during the last 10 years. A total of 22 articles were reviewed. RESULTS A great variety of substances have been found to give rise to foreign body granulomatous reactions. The most common locations are the upper and lower lip and the nasogenian sulcus. The clinical presentation is variable and can range from single or multiple nodules to diffuse facial swelling of hard-elastic consistency, accompanied by reddening. Most lesions are asymptomatic or cause only mild discomfort. The literature describes different treatments, including systemic corticosteroids, local tacrolimus infiltrations, minocycline, retinoids, allopurinol, 5% imiquimod, and surgical removal. CONCLUSIONS In view of the current demand for esthetic treatments, the use of cosmetic fillers can be expected to increase in future, together with the incidence of complications. Key words:Esthetic fillers, granulomatous reactions, foreign body reactions, cosmetic fillers.