Beauty is only mucosa deep : a retrospective analysis of oral lumps and bumps caused by cosmetic fillers

Introduction: The injection of dermal fillers into orofacial tissues is becoming increasingly popular for cosmetic purposes, in particular for lip augmentation. Both natural and synthetic filler materials are available, producing a spectrum of clinical and histological appearances.

Aims: The aim of this study was to review the clinicopathological characteristics of dermal filler cases from 2006 to 2016, reported at a specialist oral pathology unit.

Methods: An archival search of the pathology database was performed to retrieve cases reported as being consistent with cosmetic fillers.

Results: Ten cases of orofacial cosmetic fillers were retrieved. Of these cases, 100% were from female patients and the mean age of presentation was 47.6 years (range 24-68 years). The lips were the most frequently involved site (80%, n = 8). The majority of provisional diagnoses were related to salivary gland disease, including neoplasms (30%, n = 3), cysts (20%, n = 2) or inflammatory disease (10%, n = 1). Only two cases (20%) were clinically thought to be related to previous cosmetic injections. A variety of filler materials were seen, including collagen, hydroxyapatite and silicone. However, hyaluronic acid-based materials were the most common (50%, n = 5).

Conclusions: Complications of cosmetic dermal fillers are becoming more common and should be considered within a differential diagnosis for unusual orofacial swellings.