Inflammatory Complications of Soft Tissue Fillers: A Retrospective Case Series and Narrative Literature Review

Complications of soft tissue fillers (STFs) are rare, but infections and foreign body reactions can be serious and difficult to manage. This retrospective case series and narrative literature review aimed to provide an overview of inflammatory complications associated with STFs and to compare our clinical management approach with the available literature. Ten patients with inflammatory complications related to STFs were retrospectively evaluated. In addition, a narrative literature search was performed in PubMed using the following Boolean search terms: ((infection) OR (biofilm) OR (foreign body reaction)) AND ((soft tissue filler) OR (dermal filler)). The time interval between filler injection and the onset of the inflammatory reaction ranged from 2 days to 84 months and most culture results were negative. When evaluated together with the literature, antibiotic treatment appears to be more effective in acute infectious complications, whereas delayed complications may be less responsive because of biofilm formation. In late inflammatory nodules, non-surgical treatments such as hyaluronidase, intralesional triamcinolone and 5-fluorouracil may be used; however, these treatments remain controversial, and surgical excision may be required for persistent lesions.