MRI helps identify adverse Effects due to Hyaluronic Acid Filler- case report

She was then admitted to Becker and colleagues clinic. During admission, she had an approximately 2 cm large, rough, painful swelling with restricted mouth opening (interincisal distance 15 mm).

Ultrasound revealed an approximately 20 × 15 mm encapsulated mass, which matched a granulomatous melted inflammation. To reduce the inflammation, the physicians administered intravenous ampicillin/sulbactam due to the closeness of the mass to the facial nerve, and an MRI scan was performed. The MRI findings showed a polylobulated lesion that measured 13 x 10 x 15 mm in the right masseter muscle. The findings were compatible with an inflammatory nodule which was then punctured and aspirated. They found no pus, secretions or blood in the aspiration. So the physicians diagnosed the accumulation of the injected mass for hyaluronic acid filler and not for an abscess. Due to the localization and extent of the findings, the physicians decided to continue the conservative intravenous antibiotic therapy, whereby the clinical symptoms regressed.

The authors concluded, "In the case of unsuccessful long-term antibiosis and unsuccessful hyaluronidase therapy, surgical resection would have been the last option if the symptoms persist."

They further added, "Proper medical training, knowledge of the patient and an experienced handling of the therapeutics used are basic requirements for success with the lowest possible complication rate of aesthetic medicine."

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DOI: https://doi.org/10.1016/j.adoms.2021.100034