Over the years, Ms. Hoa had received filler injections in various facial areas, including her forehead, temples, nasolabial folds, and lips, at different facilities. However, she was unaware of the type of substance used and had no medical records. Recently, numerous painless, lumpy masses appeared on her forehead. Attempts to remove them by aspiration were unsuccessful and resulted in fibrotic scars.

An ultrasound performed at Tam Anh Hanoi General Hospital revealed multiple hypoechoic foci scattered subcutaneously on both sides of the patient's forehead. These foci showed no vascular proliferation or calcification and varied in size. Doctor Hoang Thi Phuong Lan, from the Orthopedic Trauma Department, explained that this condition indicates the filler has persisted for many years with no signs of reabsorption.

Doctor Lan examining Ms. Hoa. Photo: Tam Anh General Hospital

Normally, fillers are biodegradable substances that last an average of six to 18 months. "When a filler remains in the body for over three years without dissolving, and up to five years as in this patient's case, it could be liquid silicone," Doctor Lan stated. Liquid silicone is a banned substance in aesthetics because it does not dissolve, can easily migrate within tissues, causing chronic inflammation, fibrosis, granuloma formation, and facial deformities. Incomplete aspiration can damage tissues, increasing the risk of scarring and complications.

Doctors recommended surgery to remove the filler from Ms. Hoa's forehead, acknowledging the potential for scarring and the need for multiple interventions. The surgical team aspirated approximately 30 ml of clear white viscous fluid along with numerous foreign particles of varying sizes, some as large as 0,6 cm. The silicone was thoroughly removed to prevent its spread to healthy tissue, and a drain was placed in the surgical area to prevent fluid accumulation post-surgery. After discharge, the patient will require follow-up appointments for doctors to monitor her progress and plan further treatment for other affected areas.

Doctor Lan advises that individuals seeking filler injections should only do so at medical facilities with specialized plastic and aesthetic surgery departments, performed by properly trained doctors. She cautioned against receiving fillers at unlicensed spas or beauty salons. Patients should receive clear consultation regarding the type of filler, its origin, expected duration, and potential side effects.

If filler injections do not dissolve over many years, or if lumps, pain, swelling, or deformities appear, it is crucial to seek medical examination for timely treatment to prevent severe complications. Improper removal techniques can easily lead to fibrosis, extensive scarring, infection, and skin necrosis.

Thanh Ba