Trinh Lily Nguyen, McGuigan Kelly Christine, Gupta Amar
Department of Otolarynology- Head and Neck Surgery, School of Medicine, Tulane University School of Medicine, New Orleans, Louisiana.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Institution, Boston, Massachusetts.
Surg J (N Y). 2022 Mar 3;8(1):e69-e79. doi: 10.1055/s-0042-1743524. eCollection 2022 Jan.
Lip augmentation with dermal filler is rising in popularity. There are generally minimal side effects that are mild and transient. However, long-term complications may occur and include lumps, bumps, nodules, or granulomas. To better understand this uncommon but challenging outcome, we aim to perform a thorough systematic review of the published literature related to nodule or granuloma formation after cosmetic soft tissue augmentation of the lips. A search of published literature was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in April 2021 and included PubMed, ScienceDirect, Embase, Google Scholar, and Cochrane databases. The Medical Subject Headings (MeSH) terms used included the following terms: "lip filler," "hyaluronic acid," "lip injection," "lip augmentation," "silicone," "poly-L-lactic acid," "calcium hydroxyapatite," "polymethylmethacrylate," "complications," "reaction," "granuloma," and "nodule." All studies were reviewed by two independent reviewers. Any discrepancies were resolved by a third reviewer. The initial search for filler-related nodules or granulomas yielded 2,954 articles and 28 were included in the final analysis containing 66 individual cases of lip nodules. All but one patient was female. The mean age was 50 years. Nodules presented on average 35.2 months or 2.9 years after initial treatment. Thirty-seven nodules underwent histological analysis, the majority of which identified the presence of a foreign-body granuloma. Silicone was the most reported filler used followed by hyaluronic acid. Most cases resolved following multiple treatments including oral antibiotics or steroids followed by surgical excision. Understanding the sequelae of lip augmentation with filler products allows clinicians to provide safe and effective treatment. Nodules that present months to years following dermal treatment may represent a foreign-body granuloma. A combination of oral antibiotics, intralesional or oral steroids, and surgical excision successfully treated the majority of cases in our study.
使用真皮填充剂进行唇部填充日益流行。一般来说，副作用极小，且轻微短暂。然而，可能会出现长期并发症，包括肿块、凸起、结节或肉芽肿。为了更好地理解这种不常见但具有挑战性的结果，我们旨在对已发表的有关唇部美容软组织填充后结节或肉芽肿形成的文献进行全面的系统综述。
2021年4月，按照PRISMA（系统评价和Meta分析的首选报告项目）指南对已发表的文献进行了检索，检索数据库包括PubMed、ScienceDirect、Embase、谷歌学术和Cochrane数据库。使用的医学主题词（MeSH）包括以下术语：“唇部填充剂”、“透明质酸”、“唇部注射”、“唇部填充”、“硅酮”、“聚左旋乳酸”、“羟基磷灰石钙”、“聚甲基丙烯酸甲酯”、“并发症”、“反应”、“肉芽肿”和“结节”。所有研究均由两名独立的评审员进行审查。如有任何分歧，则由第三名评审员解决。
最初对与填充剂相关的结节或肉芽肿的检索产生了2954篇文章，最终分析纳入了28篇文章，其中包含66例唇部结节的个体病例。除1名患者外，所有患者均为女性。平均年龄为50岁。结节平均在初次治疗后35.2个月或2.9年出现。37个结节接受了组织学分析，其中大多数鉴定出存在异物肉芽肿。硅酮是报告使用最多的填充剂，其次是透明质酸。大多数病例在包括口服抗生素或类固醇随后手术切除的多次治疗后得到解决。
了解使用填充剂产品进行唇部填充的后遗症有助于临床医生提供安全有效的治疗。在皮肤治疗数月至数年之后出现的结节可能代表异物肉芽肿。在我们的研究中，口服抗生素、病灶内或口服类固醇以及手术切除相结合成功治疗了大多数病例。
