Periorbital Lipogranuloma Following Facial Autologous Fat Injections: Non-surgical Treatment.

Abstract

Periorbital lipogranuloma following autologous fat injection into the forehead for cosmetic facial augmentation is a recently described adverse outcome. Patients have typically been treated with surgical excision. This study evaluates the clinical characteristics of periorbital lipogranulomas, and the non-surgical treatment outcomes of these patients. This is a noncomparative, interventional case series. A retrospective analysis of clinical data and radiographic images was performed of patients with periorbital lipogranuloma following autologous fat injection. Objective treatment outcomes after intralesional triamcinolone injection and/or oral prednisolone were evaluated by measuring the size of the lipogranulomas pre- and post-treatment. Cosmetic outcomes were also assessed by the subjective satisfaction at the last visit. Twenty-seven patients were identified with periorbital lipogranuloma following facial autologous fat injection. All patients were female, the mean age was 40 ± 10 years, and 19 patients received cryopreserved fat. Twenty-one patients underwent non-surgical corticosteroid treatment. 'Resolution' was achieved in 15 patients (71%), and 'Partial Resolution' was achieved in 5 patients (24%). One patient (5%) who took oral prednisone alone showed 'No Response'. Cosmetic outcomes were classified as 'Very Satisfied' in 16 patients (76%), 'Satisfied' in 4 patients (19%), and 'Dissatisfied' in 1 patient (5%) after corticosteroid treatment. Periorbital lipogranuloma following autologous fat injection may be diagnosed by history, physical exam, and orbital imaging. Non-surgical corticosteroid treatments showed a good response with few adverse effects and should be considered as a first line of treatment of periorbital granulomas prior to conducting surgical excision. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.