Infraorbital mass long after dermal filler injection: A report of two cases

BackgroundHyaluronic acid fillers have been increasingly used throughout the world in the management of aging skin in the periocular region and other areas. ObjectiveTo evaluate very late-term orbital mass formation secondary to Hyaluronic acid filler injection into the inferior eyelid. MethodsWe report two cases that presented with a subcutaneous palpable mass localized at the right medial lower infraorbital area. Following clinical and radiological examination, surgical excision was required for the differential diagnosis of tumor. ResultsAfter pathologic examination and the finding of a foreign-body granulomatous reaction, both patients recalled that hyaluronic acid filler had once been injected into their lower eyelids approximately 10 years prior. This is consistent with the fact that dermal-filler-related granuloma formation may occur even years later in the differential diagnosis of mass lesions. ConclusionIt is suggested that patients be informed about the possible but rare mass effect in the infraorbital region. Clinicians should also attend to delayed hypersensitivity reactions, since patients may not recall details due to the length of time since injection.