Facial Plast Surg 2011; 27(1): 023-028
DOI: 10.1055/s-0030-1270415
© Thieme Medical Publishers

Soft Tissue Fillers and Biofilms

Steven H. Dayan1 , 2 , John P. Arkins3 , Renata Brindise4
  • 1Department of Facial Plastic Surgery, Chicago Center for Facial Plastic Surgery, Chicago, Illinois
  • 2Department of Otolaryngology, University of Illinois at Chicago, Chicago, Illinois
  • 3Department of Clinical Research, DeNova Research, Chicago, Illinois
  • 4Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois
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Publikationsverlauf

Publikationsdatum:
18. Januar 2011 (online)

ABSTRACT

The purpose of this study was to review the clinical course of reported hypersensitivity reactions associated with use of soft tissue fillers and the response of these reactions to treatment. In this comprehensive literature review, we identified ~40 published reports that together reported numerous adverse reactions associated with use of nonpermanent soft tissue fillers; however, very few of these reactions were consistent with type I immediate or type IV delayed hypersensitivity reactions. Based on their clinical course and response to treatment, most reported hypersensitivity reactions are likely due to an infectious process. Although there are no confirmed reports of biofilm reactions associated with nonpermanent fillers, the possibility of bacterial contaminants should be considered in acute or chronic inflammatory reactions associated with use of nonpermanent soft tissue fillers. Early treatment with antibiotics is recommended.

REFERENCES

  • 1 Sage R J, Chaffins M L, Kouba D J. Granulomatous foreign body reaction to hyaluronic acid: report of a case after melolabial fold augmentation and review of management.  Dermatol Surg. 2009;  35 (Suppl 2) 1696-1700
  • 2 Narins R S, Jewell M, Rubin M, Cohen J, Strobos J. Clinical conference: management of rare events following dermal fillers—focal necrosis and angry red bumps.  Dermatol Surg. 2006;  32 426-434
  • 3 Friedman P M, Mafong E A, Kauvar A N, Geronemus R G. Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation.  Dermatol Surg. 2002;  28 491-494
  • 4 Raulin C, Greve B, Hartschuh W, Soegding K. Exudative granulomatous reaction to hyaluronic acid (Hylaform).  Contact Dermat. 2000;  43 178-179
  • 5 Fernández-Aceñero M J, Zamora E, Borbujo J. Granulomatous foreign body reaction against hyaluronic acid: report of a case after lip augmentation.  Dermatol Surg. 2003;  29 1225-1226
  • 6 Lupton J R, Alster T S. Cutaneous hypersensitivity reaction to injectable hyaluronic acid gel.  Dermatol Surg. 2000;  26 135-137
  • 7 Cohen J L. Understanding, avoiding, and managing dermal filler complications.  Dermatol Surg. 2008;  34 (Suppl 1) S92-S99
  • 8 Gell P GH, Coombs R RA, Lachmann P J. Clinical Aspects of Immunology. 3rd ed. Philadelphia, PA: Blackwell Scientific Publications; 1975
  • 9 Patel V J, Bruck M C, Katz B E. Hypersensitivity reaction to hyaluronic acid with negative skin testing.  Plast Reconstr Surg. 2006;  117 92e-94e
  • 10 Christensen L, Breiting V, Janssen M, Vuust J, Hogdall E. Adverse reactions to injectable soft tissue permanent fillers.  Aesthetic Plast Surg. 2005;  29 34-48
  • 11 Rothschild L J, Mancinelli R L. Life in extreme environments.  Nature. 2001;  409 1092-1101
  • 12 Donlan R M, Costerton J W. Biofilms: survival mechanisms of clinically relevant microorganisms.  Clin Microbiol Rev. 2002;  15 167-193
  • 13 Narins R S, Dayan S H, Brandt F S, Baldwin E K. Persistence and improvement of nasolabial fold correction with nonanimal-stabilized hyaluronic acid 100,000 gel particles/mL filler on two retreatment schedules: results up to 18 months on two retreatment schedules.  Dermatol Surg. 2008;  34 (Suppl 1) S2-S8 discussion S8
  • 14 Flaharty P. Radiance.  Facial Plast Surg. 2004;  20 165-169
  • 15 Alijotas-Reig J, Garcia-Gimenez V. Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature.  J Eur Acad Dermatol Venereol. 2008;  22 150-161
  • 16 Bellman B. Immediate and delayed hypersensitivity reactions to restylane.  Aesthet Surg J. 2005;  25 489-491
  • 17 De Boulle K. Management of complications after implantation of fillers.  J Cosmet Dermatol. 2004;  3 2-15
  • 18 Lombardi T, Samson J, Plantier F, Husson C, Küffer R. Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases.  J Oral Pathol Med. 2004;  33 115-120
  • 19 Angus J E, Affleck A G, Leach I H, Millard L G. Two cases of delayed granulomatous reactions to the cosmetic filler Dermalive, a hyaluronic acid and acrylic hydrogel.  Br J Dermatol. 2006;  155 1077-1078
  • 20 Ghislanzoni M, Bianchi F, Barbareschi M, Alessi E. Cutaneous granulomatous reaction to injectable hyaluronic acid gel.  Br J Dermatol. 2006;  154 755-758
  • 21 Wolfram D, Tzankov A, Piza-Katzer H. Surgery for foreign body reactions due to injectable fillers.  Dermatology. 2006;  213 300-304
  • 22 Al-Shraim M, Jaragh M, Geddie W. Granulomatous reaction to injectable hyaluronic acid (Restylane) diagnosed by fine needle biopsy.  J Clin Pathol. 2007;  60 1060-1061
  • 23 Sidwell R U, Dhillon A P, Butler P E, Rustin M H. Localized granulomatous reaction to a semi-permanent hyaluronic acid and acrylic hydrogel cosmetic filler.  Clin Exp Dermatol. 2004;  29 630-632
  • 24 Mamelak A J, Katz T M, Goldberg L H, Graves J J, Kaye V N, Friedman P M. Foreign body reaction to hyaluronic acid filler injection: in search of an etiology.  Dermatol Surg. 2009;  35 (Suppl 2) 1701-1703
  • 25 Sankar V, McGuff H S. Foreign body reaction to calcium hydroxylapatite after lip augmentation.  J Am Dent Assoc. 2007;  138 1093-1096
  • 26 Vleggaar D. Soft-tissue augmentation and the role of poly-L-lactic acid.  Plast Reconstr Surg. 2006;  118 (3, Suppl) 46S-54S
  • 27 Lam S M, Azizzadeh B, Graivier M. Injectable poly-L-lactic acid (Sculptra): technical considerations in soft-tissue contouring.  Plast Reconstr Surg. 2006;  118 (3, Suppl) 55S-63S
  • 28 Bentkover S H. The biology of facial fillers.  Facial Plast Surg. 2009;  25 73-85
  • 29 Lemperle G, Gauthier-Hazan N, Wolters M, Eisemann-Klein M, Zimmermann U, Duffy D M. Foreign body granulomas after all injectable dermal fillers: part 1. Possible causes.  Plast Reconstr Surg. 2009;  123 1842-1863
  • 30 Christensen L H. Host tissue interaction, fate, and risks of degradable and nondegradable gel fillers.  Dermatol Surg. 2009;  35 (Suppl 2) 1612-1619
  • 31 Christensen L. Normal and pathologic tissue reactions to soft tissue gel fillers.  Dermatol Surg. 2007;  33 (Suppl 2) S168-S175
  • 32 Shafir R, Amir A, Gur E. Long-term complications of facial injections with Restylane (injectable hyaluronic acid).  Plast Reconstr Surg. 2000;  106 1215-1216
  • 33 Brody H J. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.  Dermatol Surg. 2005;  31 (8 Pt 1) 893-897
  • 34 Matarasso S L, Herwick R. Hypersensitivity reaction to nonanimal stabilized hyaluronic acid.  J Am Acad Dermatol. 2006;  55 128-131
  • 35 Cox S E. Clinical experience with filler complications.  Dermatol Surg. 2009;  35 (Suppl 2) 1661-1666
  • 36 Hönig J F, Brink U, Korabiowska M. Severe granulomatous allergic tissue reaction after hyaluronic acid injection in the treatment of facial lines and its surgical correction.  J Craniofac Surg. 2003;  14 197-200
  • 37 Dijkema S J, van der Lei B, Kibbelaar R E. New-fill injections may induce late-onset foreign body granulomatous reaction.  Plast Reconstr Surg. 2005;  115 76e-78e
  • 38 Ceri H, Olson M E, Stremick C, Read R R, Morck D, Buret A. The Calgary Biofilm Device: new technology for rapid determination of antibiotic susceptibilities of bacterial biofilms.  J Clin Microbiol. 1999;  37 1771-1776
  • 39 Anwar H, Strap J L, Chen K, Costerton J W. Dynamic interactions of biofilms of mucoid Pseudomonas aeruginosa with tobramycin and piperacillin.  Antimicrob Agents Chemother. 1992;  36 1208-1214
  • 40 Bjarnsholt T, Tolker-Nielsen T, Givskov M, Janssen M, Christensen L H. Detection of bacteria by fluorescence in situ hybridization in culture-negative soft tissue filler lesions.  Dermatol Surg. 2009;  35 (Suppl 2) 1620-1624
  • 41 Pecharki D, Petersen F C, Scheie A A. Role of hyaluronidase in Streptococcus intermedius biofilm.  Microbiology. 2008;  154 (Pt 3) 932-938
  • 42 Jayaraman A, Wood T K. Bacterial quorum sensing: signals, circuits, and implications for biofilms and disease.  Annu Rev Biomed Eng. 2008;  10 145-167
  • 43 Cassuto D, Marangoni O, De Santis G, Christensen L. Advanced laser techniques for filler-induced complications.  Dermatol Surg. 2009;  35 (Suppl 2) 1689-1695
  • 44 Yagi Y, Kato K, Murakami D et al.. Use of Aquamid as a filler for facial rejuvenation in orientals.  J Plast Reconstr Aesthet Surg. 2009;  62 1245-1249
  • 45 Moadab A, Rupley K F, Wadhams P. Effectiveness of a nonrinse, alcohol-free antiseptic hand wash.  J Am Podiatr Med Assoc. 2001;  91 288-293
  • 46 Attila C, Ueda A, Wood T K. 5-Fluorouracil reduces biofilm formation in Escherichia coli K-12 through global regulator AriR as an antivirulence compound.  Appl Microbiol Biotechnol. 2009;  82 525-533
  • 47 Nyhlén A, Ljungberg B, Nilsson-Ehle I, Odenholt I. Bactericidal effect of combinations of antibiotic and antineoplastic agents against Staphylococcus aureus and Escherichia coli.  Chemotherapy. 2002;  48 71-77

Steven H DayanM.D. 

Department of Facial Plastic Surgery, Chicago Center for Facial Plastic Surgery

845 N. Michigan Avenue, Suite 923 E, Chicago, IL 60611

eMail: sdayan@drdayan.com

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