Delayed complication after lip contour plasticity with a hyaluronic acid-based product: a case report

Cover Page

Cite item

Full Text

Abstract

A clinical case of a 38-year-old patient with persistent swelling of the upper lip that occurred one year after contour plastic surgery with hyaluronic acid fillers is presented. The correction history includes four procedures using medium-viscosity hyaluronic acid fillers in the period from 2018 to 2021, while all injected products were not registered as drugs in the Russian Federation. The swelling developed in 2024 against the background of a stressful situation. Conservative therapy with antihistamines was ineffective. An objective examination revealed asymmetric swelling of the upper lip with a palpable compaction. Consultations with specialists of other pathology profiles did not reveal any pathology. Ultrasound-controlled filler removal was performed. This case illustrates the need to select certified drugs to minimize the risk of complications and emphasizes the effectiveness of using ultrasound control when injecting a solution of bovhyaluronidase azoximer into the filler area.

About the authors

Marina M. Tlish

Kuban State Medical University

Email: marina@netzkom.ru
ORCID iD: 0000-0001-9323-4604

D. Sci. (Med.), Prof.

Russian Federation, Krasnodar

Marina I. Sashko

Kuban State Medical University

Email: marina@netzkom.ru
ORCID iD: 0000-0002-5127-1519

Cand. Sci. (Med.)

Russian Federation, Krasnodar

Marina E. Shavilova

Kuban State Medical University

Author for correspondence.
Email: marina@netzkom.ru

Cand. Sci. (Med.)

Russian Federation, Krasnodar

Anna Yu. Boltava

Collaboration LLC

Email: annaboltava@mail.ru
ORCID iD: 0009-0008-6845-5788

Chief doctor, New You Сlinic 

Russian Federation, Krasnodar

Fatima A. Psavok

Kuban State Medical University

Email: marina@netzkom.ru
ORCID iD: 0000-0002-9556-1956

Cand. Sci. (Med.)

Russian Federation, Krasnodar

References

  1. Тлиш М.М., Сашко М.И., Шавилова М.Е., и др. Ботулотоксин в современной косметологической практике: от высокой эффективности к проблеме осложнений (анализ клинического наблюдения). Врач. 2024;35(4):67-71 [Tlish MM, Sashko MI, Shavilova ME, et al. Botulinum toxin in modern cosmetology practice: from high efficiency to the problem of complications (analysis of clinical observation). Vrach. 2024;35(4):67-71 (in Russian)]. doi: 10.29296/25877305-2024-04-13
  2. Юцковская Я.А., Кислицына А.И., Байбарина Е.В., и др. Гиалуронидаза: опыт лечения осложнений после введения филлеров. Инъекционные методы в косметологии. 2019;2:4-17 [Yuczkovskaya YaA, Kislicyna AI, Bajbarina EV, et al. Hyaluronidase: experience in treating complications after filler injection. Injection methods in cosmetology. 2019;2:4-17 (in Russian].
  3. Narins RS, Jewell M, Rubin M, et al. Clinical conference: Management of rare events following dermal fillers. Focal necrosis and angry red bumps. Dermatol Surg. 2006;32:426-34. doi: 10.1111/j.1524-4725.2006.32086.x
  4. Oranges CM, Brucato D, Schaefer DJ, et al. Complications of nonpermanent facial fillers: a systematic review. Plastic Reconstruct Surg Global Open. 2021;9(10):e3851. doi: 10.1097/GOX.0000000000003851
  5. Kroumpouzos G, Harris S, Bhargava S, et al. Complications of fillers in the lips and perioral area: prevention, assessment, and management focusing on ultrasound guidance. J Plast Reconstruct Aesthetic Surg. 2023;84:656-69. doi: 10.1016/j.bjps.2023.01.048
  6. Jeong CH, Yune JH, Kwon HC, et al. In vitro toxicity assessment of crosslinking agents used in hyaluronic acid dermal filler. Toxicol Vitro. 2021;70:105034. doi: 10.1016/j.tiv.2020.105034
  7. Lee W, Shah-Desai S, Rho NK, et al. Etiology of delayed inflammatory reaction induced by hyaluronic acid filler. Arch Plast Surg. 2024;51(01):020-6. doi: 10.1055/a-2184-6554
  8. Koh IS, Lee W. Filler Complications: Filler-induced hypersensitivity reactions, granuloma, necrosis, and blindness. Filler complications. 1st ed. Singapore: Springer; 2019. doi: 10.1007/978-981-13-6639-0
  9. Ibrahim O, Overman J, Arndt KA, et al. Filler nodules: inflammatory or infectious? A review of biofilms and their implications on clinical practice. Dermatol Surg. 2018;44(01):53-60. doi: 10.1097/DSS.0000000000001202
  10. Funt DK. Treatment of delayed-onset inflammatory reactions to hyaluronic acid filler: an algorithmic approach. Plast Reconstr Surg Glob Open. 2022;10(06):e4362. doi: 10.1097/GOX.0000000000004362
  11. Тлиш М.М., Шавилова М.Е., Матишев А.А. Особенности ультразвуковой картины ногтевой пластины и окружающих ее тканей у пациентов с онихомикозом стоп. Инфекционные болезни. 2020;18(4):169-76 [Tlish MM, Shavilova ME, Matishev AA. Features of the ultrasound image of the nail plate and surrounding tissues in patients with onychomycosis of the feet. Infectious diseases. 2020;18(4):169-76 (in Russian)]. doi: 10.20953/1729-9225-2020-4-169-176
  12. Levy J, Barrett DL, Harris N et al. High-frequency ultrasound in clinical dermatology: a review. Ultrasound J. 2021;13:24. doi: 10.1186/s13089-021-00222-w
  13. Бондаренко И.Н. Ультразвуковое исследование высокого разрешения в диагностике отеков после контурной пластики. Кубанский научный медицинский вестник. 2021;28(1):32-42 [Bondarenko IN. High-resolution ultrasonic diagnostics in post-contouring oedema. Kuban Scientific Medical Bulletin. 2021;28(1):32-42 (in Russian)]. doi: 10.25207/1608-6228-2021-28-1-32-42

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Patient V., pathological process before the start of therapy.

Download (113KB)
3. Fig. 2. Ultrasound of the initial examination: a – area of ​​the cutaneous part of the upper lip; b – projection of the philtrum columns; c – area of ​​the mucous membrane of the upper lip; d – area of ​​the right nasolabial fold; e – area of ​​the left nasolabial fold.

Download (186KB)
4. Fig. 3. Ultrasound of the control appointment: a – skin part of the upper lip; b – projection of the philtrum columns; c – mucous membrane of the upper lip.

Download (169KB)

Copyright (c) 2025 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).