Hypersensitivity to injectable porcine collagen
Dr. Ziwei XIE
MD, Singapore
October 14th, 2025 10:45
Patient description
42 year old Chinese lady
Healthy with no medical condition. No history of food allergy or drug allergy.
Case description
Came to me for management of tear trough and palpebromalar groove. However due to poor perception of hyaluronic filler, request for other injectables. Sunmax deusaderm vital , an injectable collagen gel from SPF porcine skin was offered.
She did hydrafacial followed by topical BLT cream for topical anaesthesia around the orbit.
0.2ml of 1% lidocaine was mixed into 1ml of collagen gel.
0.1ml was injected into the lateral orbital thickening using sharp needle. 25G cannula was inserted at around 1.5cm inferior to the lateral orbital rim. 0.15ml deep bolus using cannula into the intersecting point of tear trough ligament, orbital retaining ligament and zygomatic cutaneous ligament.
0.05ml was injected linear retrograde deep into the depression of tear trough. The rest was hyperdiluted 1:1 with 1% lidocaine and distributed superficial around the infraorbital area from lid margin to infra orbital rim.
Immediately I noticed unusual erythema along the cannala path as well as areas injected superficial. This has not happened in my prior 30 odd cases. I brushed it off as secondary to trauma of cannulation.
Patient called up the next day. She developed significant swelling and erythema 1 hour after procedure while she was on her was home. It worsen the next morning. She had blanchable erythema and and swelling lower eyelid, entire medial cheek, glabella and bilateral upper temple. The reaction was localised.
Photo attached are before procedure, immediately after precedure ( notice the erythema ) and 20 hours after procedure.
She was started on oral prednisolone 20mg per day and ceftrizine 10mg twice dail 4 hours ago.
Will like to ask expert about the management of localised hypersensitivity reaction to procine collagen in her case. Thanks.
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Dr. Ronald FEINER
MD, Australia
November 15th, 2025 11:02
Dr. Ziwei XIE
MD, Singapore
November 15th, 2025 09:22
Dr. Ronald FEINER
MD, Australia
October 15th, 2025 06:39
Dr. Ziwei XIE
MD, Singapore
October 15th, 2025 06:11
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Dr. Ronald FEINER
MD, Australia
October 15th, 2025 04:26
Dr. Ziwei XIE
MD, Singapore
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