I have a foreign body granuloma on my cheek from Juvederm Ultra filler 2 months post injection, terrified (Photo)

I suggest you see an expert, this can be improved in the office and most patients are very happy after treatments. Best, Dr. Emer.

I am so sorry that you've experience this. It is, thankfully, very rare. However, I think you should see your surgeon about having the filler removed. Best of luck, Dr. Nazarian

You need to have some hyaluronidase injected to remove the Juvederm.  This may need to be done a couple of times.  Then the oral steroids are helpful.  Can also do another steroid injection if necessary after the Juvederm dissolved.  Just have to be careful with steroid injections as they can leave a depression.   

I would be very interested in learning more about what you have been through. This is very difficult to treat. You should have injections of hyaluronidase to dissolve the hyaluronic acid filler and prednisone pills can help also. I encourage you to contact me via my website at charlotteskinandlaser I am sorry you are having this complication and I sincerely hope it clears up very soon.

Thank you for your question.  Granulomas after soft hyaluronic acid fillers are extremely rare, this would need to be biopsied for a definitive diagnosis of a granuloma.  To me this degree of swelling is either an infection or a hematoma.  This should be treated definitively with hyaluronidase and oral antibiotics particularly one with coverage for staph infections, for example Doxycycline.  While normally if a granuloma was suspected I would agree with intralesional and oral steroids, I think in this case since it is suspicious for an infection, I would hold off on steroids, treat with hyaluronidase and antibiotics.  If it resolves no need for further steroids, if it does not resolve than a biopsy would be warranted to determine if it is truly a granuloma which would lead you down the steroid path as well as possible intralesional 5FU.  Please follow up with your board certified Dermatologist for proper evaluation and management.  Regards, Dr. Matt Elias

The degree of swelling and the erythema (redness) of the surrounding area would indicate that you may have an infection.  This could be associated with a hematoma but not necessarily.  I agree with the other comments that have been made in that hyaluronidase and antibiotics are necessary.  if this does not improve rather rapidly within a few days then further investigation is warranted.

This diagnosis (foreign body granuloma) is done with a histological sample usually (a biopsy). Without it, I'd treat this as an infection. It needs to be dissolved and treat with antibiotics. I'd treat with an anti MRSA drug, and if no response, consider more unusual infections such as atypical mycobacterium. Most of these problems are related to poor sterile technique. The product is very safe and used millions of times throughout the world without problems like this. If you are not improving, you need to see someone else. If the product is removed, the problem should be minimized with hyaluronidase.

You raise a lot of interesting issues here with the Juvederm "granuloma"  The beauty of the hyaluronic acid family is the reversal with hyaluronidase which occurs in a very quick time period after injection.  Steroid injections should play no part with this in that you could have fat necrosis within your face if injected incorrectly.  I hope that this area is doing better now.

If you have a severe reaction to the filler and it needs to be dissolved then hyaluronidase is the product to have injected.

Thankfully, this is very rare. I think the way that you're being treated is sound. However, you require hyaluoridase to remove the product entirely. Granulomas after hyaluronic acid fillers are incredibly rare. The best next step is to remove the product now. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon