Unpredictable findings after silicone filler: “leonine facies-like” reaction

Abstract

A 76-year-old woman presented with facial edema and nodules in the front glabellar region and nasal dorsum that clinically resembled leonine facies. A facial ultrasound showed deposits of permanent facial filler with a "snowstorm" aspect characteristic of silicone oil, and an anatomopathological examination suggested a granulomatous reaction to the exogenous substance. Permanent fillers, such as silicone, behave like foreign bodies and cause a chronic granulomatous reaction. Although dermal fillers have been increasingly used, there is still no consensus on the management of their complications. In the present case, a good response to dapsone was observed.

Keywords

• silicones
• dermal fillers
• granulomatous disease, chronic
• foreign-body reaction