Imaging Sci Dent.  2018 Sep;48(3):227-231. 10.5624/isd.2018.48.3.227.

Radiographic study of dermal fillers in the facial area: A series of 3 cases

• Kwon YE
• An CH
• Choi KS
• Lee DH
• An SY

• KMID: 2420551
• DOI: http://doi.org/10.5624/isd.2018.48.3.227

Abstract

In recent years, as interest in maintaining beauty and a youthful appearance has grown, filler procedures such as soft tissue augmentation have become more popular. These fillers are sometimes seen as radiopaque shadows on radiographic images, either due to the fillers themselves or because of secondary reactions; such findings may present a diagnostic challenge to dentists. The present report describes 3 cases of dermal fillers observed in panoramic and cone-beam computed tomographic (CBCT) images. All 3 elderly female patients had filler injected into their cheeks and chin area for cosmetic purposes decades ago. On panoramic images, multiple symmetric radiopacities were observed in the facial area; on CBCT, these calcifications were seen in the subcutaneous tissue in various shapes and with varying density. In conclusion, dentists should be aware of the imaging characteristics of dermal filler, and should be able to differentiate dermal filler from other pathological findings.

Keyword

Dermal Fillers; Radiography, Panoramic; Cone-Beam Computed Tomography

MeSH Terms

Adolescent
Aged
Beauty
Cheek
Chin
Cone-Beam Computed Tomography
Dentists
Dermal Fillers*
Female
Humans
Radiography, Panoramic
Subcutaneous Tissue
Dermal Fillers

Figure

• 

  Fig. 1 Panoramic radiograph (A) and axial (B), coronal (C), and 3-dimensional reconstruction (D) of cone-beam computed tomographic images of case 1, demonstrating multiple, amorphous radiopaque masses varying in size in the bilateral cheek areas. Some of the calcifications have a radiolucent center surrounded by a radiopaque rim (arrow). Red dots indicate the mandibular canals.

• 

  Fig. 2 Panoramic radiograph (A) and axial view (B), coronal view (C), and 3-dimensional reconstruction (D) of cone-beam computed tomographic images of case 2, showing a cluster of small and discrete calcifications on both cheeks and in the right chin area.

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  Fig. 3 Panoramic radiograph (A) and coronal (B) cone-beam computed tomographic images of case 3, showing small ring- and nodule-shaped calcifications in both chin areas.

Reference

1. Kontis TC, Rivkin A. The history of injectable facial fillers. Facial Plast Surg. 2009; 25:67–72. PMID: 19415573.

2. Chacon AH. Fillers in dermatology: from past to present. Cutis. 2015; 96:E17–E19.

3. Alsaadi G, Jacobs R, Quirynen M, van Steenberghe D. Soft tissue augmentation of the cheeks detected on intra- and extraoral radiographs: a case report. Dentomaxillofac Radiol. 2008; 37:117–120. PMID: 18239040.

4. Ginat DT, Schatz CJ. Imaging features of midface injectable fillers and associated complications. AJNR Am J Neuroradiol. 2013; 34:1488–1495. PMID: 22837310.

5. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006; 72:75–80. PMID: 16480609.

6. Quirino MR, Neves AC, Campos MS, Brandão AA, Anbinder AL. Oral granuloma formation after injection of cosmetic filler. J Craniomaxillofac Surg. 2012; 40:e194–e197. PMID: 22100454.

7. Daley T, Damm DD, Haden JA, Kolodychak MT. Oral lesions associated with injected hydroxyapatite cosmetic filler. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114:107–111. PMID: 22727099.

8. Mupparapu M, Mozaffari E. Bilateral calcifications secondary to synthetic soft tissue augmentation of the cheeks: report of a case. Dentomaxillofac Radiol. 2002; 31:388–390. PMID: 12424639.

9. Vazquez J, Rosenthal DI. Bilateral, symmetrical soft tissue calcifications in the face. Skeletal Radiol. 2010; 39:387–389. PMID: 20049592.

10. Valiyaparambil J, Rengasamy K, Mallya SM. An unusual soft tissue radiopacity - radiographic appearance of a dermal filler. Br Dent J. 2009; 207:211–212. PMID: 19749712.

11. Carruthers A, Liebeskind M, Carruthers J, Forster BB. Radiographic and computed tomographic studies of calcium hydroxylapatite for treatment of HIV-associated facial lipoatrophy and correction of nasolabial folds. Dermatol Surg. 2008; 34(Suppl 1):S78–S84. PMID: 18547186.

12. Mandel L, Addison S, Clark M. Buccal reaction to silicone cosmetic filler. J Am Dent Assoc. 2010; 141:162–166. PMID: 20123874.

13. Verpaele A, Strand A. Restylane SubQ, a non-animal stabilized hyaluronic acid gel for soft tissue augmentation of the mid- and lower face. Aesthet Surg J. 2006; 26:S10–S17. PMID: 19338970.