Massive granulomatous reaction

Injectables
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Anonymous

August 4th, 2025 15:44

Patient description

55a old female patient, no medication

Case description

The patient has been injected with Tesosyal RHA4 (0,7cc) in the area of the marionette lines and cheeks several weeks ago . After the injection she developed a hematoma on both sides of the marionette lines, which disappeared 1 week later.  1 month after the injection she developed this granulomatous reaction, red, painful and hard on palpation. She received Hyaluronidase intralesional injections, which made the problem worse. Oral corticoids (Urban 2x25 mg for 5 days) have been prescribed, without improvement.  2 days ago she started to take Doxycyclin. Today the patient says, that she noticed some improvement.

What would you suggest? Still waiting and see, if the Tetracycline does it´s job? Making a puncture? Intralesional steroids? 5 FU intralesional?

Thank you so much!

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Dr. Hugues CARTIER

Dermatologist, France

October 5th, 2025 14:16

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Dr. Kuldeep SINGH

Plastic Surgeon, India

September 3rd, 2025 03:31

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Anonymous

August 24th, 2025 20:09

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Prof Daniel CASSUTO

Plastic Surgeon, Italy

August 24th, 2025 08:23

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Dr. Robyn D SIPERSTEIN

Dermatologist, United States

August 12th, 2025 07:17

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Dr. Tzachi SHELKOVITZ

Dermatologist, Israel

August 8th, 2025 07:57

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Dr. Anna AVALIANI

Cosmetic Surgeon, United States

August 5th, 2025 17:04

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August 5th, 2025 11:27

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Dr. Ronald FEINER

MD, Australia

August 5th, 2025 11:54

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Dr. Ronald FEINER

MD, Australia

August 5th, 2025 09:54

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Dr. Steven F WEINER

Facial Plastic Surgeon, United States

August 5th, 2025 02:27

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Dr. Stella DESYATNIKOVA

Facial Plastic Surgeon, United States

August 4th, 2025 21:37

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Anonymous

August 4th, 2025 19:57

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Dr. Anna AVALIANI

Cosmetic Surgeon, United States

August 4th, 2025 19:43

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Dr. Fadi HAMADANI

Plastic Surgeon, Palestine

August 4th, 2025 16:57

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Dr. Steven F WEINER

Facial Plastic Surgeon, United States

August 4th, 2025 16:31

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Dr. Jair Mauricio CERON BOHORQUEZ

Cosmetic Surgeon, Germany

August 4th, 2025 16:16

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