Korean J Ophthalmol.  2016 Feb;30(1):10-16. 10.3341/kjo.2016.30.1.10.

Periorbital Lipogranuloma after Facial Autologous Fat Injection and Its Treatment Outcomes

• Park JY
• Kim N

• KMID: 2363885
• DOI: http://doi.org/10.3341/kjo.2016.30.1.10

Abstract

PURPOSE
To investigate periorbital lipogranuloma cases that developed after autologous fat injection and to determine various treatment outcomes from these cases.
METHODS
This retrospective study involved 27 patients who presented with periocular mass (final diagnosis of lipogranuloma) and had history of facial autologous fat injection. The collected data included information on patient sex, age, clinical presentation, number and site of fat injections, interval between injections, duration from injection to symptom onset, fat harvesting site, use of cryopreservation, and treatment outcome.
RESULTS
The most common presenting symptom was palpable mass (92.6%), followed by blepharoptosis and eyelid edema. The mean time from injection to symptom onset was 13.6 +/- 29.2 months (range, 2 to 153 months). Patients were managed by intralesional triamcinolone injection (six patients) and surgical excision (three patients); 18 patients were followed without treatment. Among the six patients who underwent intralesional triamcinolone injection, five showed complete resolution, and one showed partial resolution. Among the 18 patients who were followed without management, three showed spontaneous resolution over a 5-month follow-up period.
CONCLUSIONS
Lipogranuloma can develop in the eyelid after autologous fat injection into the face. Both surgical excision and intralesional triamcinolone injection yield relatively good outcomes. Simple observation can be a good option because spontaneous resolution can occur in a subset of patients.

Keyword

Autologous fat injection; Periorbital lipogranuloma

MeSH Terms

Adipose Tissue/*transplantation
Adult
Autografts
Cosmetic Techniques/*adverse effects
Eyelid Diseases/diagnostic imaging/*etiology/therapy
Female
Granuloma, Foreign-Body/diagnostic imaging/*etiology/therapy
Humans
Injections
Magnetic Resonance Imaging
Male
Middle Aged
Orbital Diseases/diagnostic imaging/*etiology/therapy
Retrospective Studies
Rhytidoplasty/*adverse effects
Young Adult

Figure

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  Fig. 1 (A) A 29-year-old woman presenting with a 3-month history of palpable mass in the right upper eyelid (asterisk) that developed 10 months after an injection of cryopreserved autologous fat into her face. (B) A T1-weighted axial magnetic resonance image shows a fat-containing lesion with peripheral enhancement (arrow) and adjacent skin enhancement in the right upper eyelid. (C,D) Typical findings of granulomatous foreign body reaction with diffusely infiltrated chronic granulomatous inflammatory cells with fat necrosis and fibrosis (hematoxylin and eosin stain, ×100, ×400).

• 

  Fig. 2 (A) A 31-year-old woman presenting with a 3-week history of palpable mass in the right upper eyelid (asterisk) that developed 7 months after an injection of cryopreserved autologous fat into her forehead. (B) A T2-weighted coronal image reveals multiple lesions (arrows) of heterogeneous high signal intensity in both upper eyelids.

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