Orbital Mass Formation a Decade After Hyaluronic Acid Filler Injections

Hyaluronic acid fillers, commonly employed for rejuvenating aging skin, have now come under scrutiny for potential long-term complications, as highlighted in a recent report in the Journal of Cosmetic Dermatology that detailed 2 cases of infraorbital mass formation long after dermal filler injection.

The study, focusing on the periocular region and other areas, sought to evaluate very late-term orbital mass development resulting from hyaluronic acid filler injection into the inferior eyelid. The 2 cases presented with a subcutaneous palpable mass localized at the right, medial, lower infraorbital area, prompting clinical and radiologic examination. Surgical excision became necessary for a differential diagnosis ruling out a tumor.

Results from pathologic examination revealed a foreign-body granulomatous reaction, leading both patients to recollect hyaluronic acid filler injections into their lower eyelids approximately 10 years prior. This discovery sheds light on the possibility of dermal filler-related granuloma formation occurring years later, emphasizing the importance of considering such complications in the differential diagnosis of mass lesions.

“It is suggested that patients be informed about the possible but rare mass effect in the infraorbital region,” concluded the study authors. “Clinicians should also attend to delayed hypersensitivity reactions, since patients may not recall details due to the length of time since injection.”

Reference

Arici C, Tosuner Z. Infraorbital mass long after dermal filler injection: a report of two cases. J Cosmet Dermatol. Published online January 6, 2023. doi: 10.1111/jocd.15583.