Abstract
While dermatologic fillers are a safe and effective choice for cosmetic correction, possibilities for complications remain, including filler-induced granuloma. Polycaprolactone (PCL) is a relatively new filler material with lower granuloma complication rates. A 57-year-old woman who had received a tear-trough injection with PCL filler seven months prior to her visit presented with a nodular lesion near the inner canthus of her left lower eyelid. Excisional biopsy revealed granulomatous inflammation and multinucleated giant cell-engulfed foreign material with birefringence, indicative of PCL-filler-induced granuloma. Follow-up after excision showed no recurrence. Literature for PCL granuloma complications is scarce, with only two previous articles reporting pathological diagnosis. Observation is a viable treatment option, while other options include massage, oral doxycycline or macrolides, and excision, among others. Physicians should keep in mind this rare but possible complication when presented with a granulomatous lesion with no apparent etiology.
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