An Unusual Delayed Type Reaction Following Periorbital Filler Injection With Hyaluronic Acid.

Hyaluronic acid fillers have been increasingly popular for soft tissue augmentation. Although generally considered safe, early and delayed types of adverse events were reported. We describe an unusual delayed type reaction observed with hyaluronic acid filler in a series of three patients treated for tear trough and periorbital hollow. Patients presented with a unilateral lower eyelid swelling without palpable nodules or tenderness developing months after injection and disappearing in few days. Reaction was triggered by infection in two patients. Temporary lower eyelid swelling is another late complication of periorbital filler injection that was not reported previously.