Adverse Cutaneous Reactions to Soft Tissue Fillers: A Review of the Histological Features

In 2008, a review was conducted on the histological features of adverse cutaneous reactions to soft tissue fillers. The review aimed to increase awareness of the diverse reactions to different filler products, noting that biodegradable fillers typically do not cause granulomatous reactions and are metabolized by human enzymes. Adverse reactions can be immediate or delayed, with late reactions including granulomatous responses. Factors such as procedural techniques, product concentration, and impurities, as well as infections, can influence the degree of response. The document also discusses the histological reaction patterns to different fillers, such as foreign body granuloma for silicone, and foreign body giant cell reactions for hyaluronic acid fillers. It highlights that understanding the histological features associated with adverse reactions is crucial for proper diagnosis and management. Non-biodegradable fillers like silicone can cause long-term issues such as firm subcutaneous nodules and other adverse reactions. The review underscores the importance of physician awareness of potential complications from soft tissue fillers.