Buccal reaction to silicone cosmetic filler.

BACKGROUND: Administering injections of dermal fillers has become a popular office procedure that is performed to restore facial volume, augment facial volume or both. Injectable silicone is a nonbiodegradable filler that was introduced 40 years ago. Adverse reactions can develop from its long-term presence in the body. CASE DESCRIPTION: The authors evaluated a 45-year-old woman who nine years previously had received bilateral silicone cosmetic filler injections in the malar regions of her face. Two years and again five years later, she developed painless buccal swellings on the right side of her face, but the condition regressed spontaneously. When a third episode of right buccal swelling persisted, she sought care. Therapy involving the use of antibiotic agents and steroids resolved the patient's reaction to the silicone, but the pathophysiology of the reaction has not been delineated clearly. CONCLUSION AND CLINICAL IMPLICATIONS: Dental practitioners may see orofacial inflammatory swellings initiated by a reaction to silicone. Differentiating it from facial cellulitis is essential. Practitioners should base their diagnoses of orofacial inflammatory swellings on patients' history of receiving injectable cosmetic filler.