i developed a foreign body granuloma from juvaderm ultra in cheek it's been 6 weeks around about have had one steroid injection and on oral steroids 25mg daily it has improved but still up and down with swelling in cheek area and around the eye and pain which I take Ibrofen for almost looks like "footprints " what is the next step ? More injections are they harmful ? Or surgery to remove the tissue??
November 2, 2015
Answer: Juvederm reaction 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.
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November 2, 2015
Answer: Juvederm reaction 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.
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November 4, 2015
Answer: Granuloma and Ultra 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
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November 4, 2015
Answer: Granuloma and Ultra 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
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