Treatment of Delayed Reactions to Dermal Fillers

A definitive explanation of the mechanism of delayed reactions to dermal fillers remains elusive. Such reactions, although very rare with current FDA-approved injectable fillers, may appear weeks, months, or years after the injectable procedure as indurated papules or nodules with or without redness and tenderness. Many lines of evidence suggest one cause may be up-regulation of immune function that is stimulated by a local infectious process including biofilm. Delayed hypersensitivity to some component or metabolite of the injected filler is another possibility.