Management of Visible Granulomas Following Periorbital Injection of Poly-L-Lactic Acid

    Daniel B. Stewart, Greg S. Morganroth, Maureen A. Mooney, Joel L. Cohen, Peter S. Levin, Hayes B. Gladstone
    TLDR Surgical excision is an effective treatment for persistent nodules from poly-L-lactic acid injections.
    The study discussed the management of visible granulomas following periorbital injection of poly-L-lactic acid (PLA), a soft-tissue filler approved for HIV-associated lipoatrophy but increasingly used for cosmetic purposes. The authors described a case where a patient developed granulomatous reactions resulting in visible papules. After reviewing various medical and surgical treatment options, they found that surgical excision provided excellent results, being minimally invasive and leaving minimal scarring. The study concluded that due to the high frequency of subcutaneous nodule formation with PLA, physicians should be well-informed about potential side effects and consider surgical excision as a viable treatment for persistent nodules.
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