Orbital cellulitis reported after use of facial soft-tissue filler

Dr Paul Ikgan Sia, from the Royal Adelaide Hospital in Australia, and colleagues describe the case of a 49-year-old female who presented with 12 months of recurrent left cheek inflammation that did not resolve with six courses of antibiotics. She described a thickened, indurated, and erythematous area in her left cheek, which became worse after subcutaneous triamcinolone injection into the affected area. The extraocular movements on the left were significantly restricted on examination.

The researchers identified two orbital abscesses on magnetic resonance imaging, which were incised and drained, with subsequent recovery. Two months later the patient presented with a relapse of orbital cellulitis. On surgical exploration, a permanent left cheek cable suture was identified; gelatinous material was present at the inferior end of the suture. On further postoperative questioning, the patient confirmed having had nasojugal fold or lower cheek permanent soft-tissue filler injection and cheek-lifting cable sutures inserted six years earlier.

The gelatinous material was confirmed as permanent silicone filler. The patient recovered and was free of recurrence at 12-months follow-up.

“Although orbital complications from soft-tissue fillers are very rare, they can be potentially sight-threatening,” the authors write.

Delayed and recurrent orbital cellulitis following use of facial soft-tissue filler is described in a case report published online Feb 10 in Clinical & Experimental Ophthalmology.

Source: Wiley Online Library,