Granuloma

Complications of fillers

Filler injections to fill volumetric deficits and eliminate wrinkles are one of the most used aesthetic procedures in the world. The increased demand and growth of different types of fillers means that the complication rate associated with these injections is constantly increasing. Non-resorbable fillers remain for years in the tissues and can potentially cause inflammation problems at all times. Inflammatory complications after injection of non-resorbable fillers are often called granulomas. This term refers to inflammatory lesions that appear as nodular formations characterized by an abundant proliferation of macrophages, multinucleated giant cells, proteins, fibroblasts and angiogenesis. This definition is on a histological basis, in the absence of a histological diagnosis we prefer to speak of 'inflammatory nodules'. These lesions appear as nodules structured in an orderly and characteristic manner depending on the pathogen that triggered its formation. The intuition of a treatment that was effective and at the same time minimally invasive was the late dr. Ovidio Marangoni who performed the first cases in Italy in 2006. Afterwards, a medical team together with Eufoton studied for years the positive effect of the laser used to try to solve these complications. Let's see the process and the effects.
 

Filler granuloma treated with ILT

 
  • info_outline Read More

    Correcting filler granulomas with ILT lasers

    ILT - Interstitial Laser Treatment - is the first technique to effectively and permanently eliminate granulomas caused by permanent fillers. These granulomas come from swelling and hardening that can occur around the area where fillers were injected due to a rejection of the substances used, which may not integrate perfectly with the tissue. To date, granulomas have always been treated with local injections of corticosteroids, antitumor drugs or with surgery. The results, however, are never satisfactory: in most cases, there is only a temporary improvement with the risk of obvious scaring, atrophy and tissue depressions. The laser, on the other hand, evacuates most of the filler and definitively stops the inflammatory process without leaving any obvious traces.

    How does the ILT laser work?

    The laser light transmitted through an optical microfiber into the granuloma works at three levels.
    Firstly, it warms the area, melting the filler. Being heat sensitive, all permanent fillers pass from the solid state to the liquid state due to this thermal effect. The molten substance comes out of the microscopic hole used to insert the optical fiber.
     
    Secondly, the increase in temperature caused by the laser necrotizes the inflammatory tissue that always generates around the granuloma. A sterile pus therefore forms, which also emerges from the small holes. In some cases a very small incision may need to be made (especially when the granuloma is large) after about a month in order to completely eliminate the material.
    It is also hypothesized that the laser acts on the so-called "biofilm", a still unproven phenomenon, but which is increasingly accepted by industry experts. According to many experts, when a granuloma is formed, some bacteria colonize the surface contacting the injected substances and the tissue, causing a protective inflammatory reaction (the inflammatory molecules destroy the bacteria).
     
    In reality, this is not what happens: the bacteria create a membrane that envelops and protects them: the inflammation process therefore does not shut off and it becomes chronic. This would explain why drugs only have temporary success: after their effect, the reaction starts up again. The presence of bacteria would explain the very high percentage of recurrence after treatments with cortisone and other immunosuppressive agents. For ablative surgery, there is another explanation for the poor efficacy: the surgeon spreads the biofilm bacteria around the area with the scalpel. The bacterial reactivate after a short period of time, thus worsening the inflammatory phenomenon. The increase in temperature created by the laser, on the other hand, kills the bacteria and cures the inflammation
     
                   
     
    Filler Granuloma Removal - Courtesy of D. Cassuto, MD
Find your laser

Are you interested in a laser or in an accessory?

commentAsk for consulationcomment
REQUEST FOR CONSULTATION

Do you need help? Fill in the form and we will help you solve it.

!

!

Disclosures
Some of the information contained in this website are exclusively directed to healthcare professionals, in compliance with art. 21 of the Decree n. 46 of February 24th, 1997 and subsequent modifications and integrations, and the Guidelines of the Italian Ministry of Health of March 28th, 2013. The possibility to continue browsing and access to the content relating to products, technical descriptions and commercial offers is subject to the statement made by the user, under his own responsibility, to be a healthcare professional. The simple visitors will be redirected to institutional page of Eufoton.
Cookie Policy

This website uses cookies. By continuing to browse this site, you are agreeing to our use of cookies. Find out more by clicking here. ABILITA or DISABILITA.

By pressing Continue I declare under my own responsibility to be a healthcare provider and continuing to browse I declare to accept the cookie information.

I am a health worker
Continue arrow_forward
I am a visitor
Home arrow_forward