Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1
Fig. 2


  1. Lombardi T, Samson J, Plantier F, Husson C, Kuffer R. Orofacial granulomas after injection of cosmetic fillers. Histopathologic and clinical study of 11 cases. J Oral Pathol Med 2004; 33: 115-120.

  2. Eversole R, Tran K, Hansen D, Campbell J. Lip augmentation dermal filler reactions, histopathologic features. Head Neck Pathol 2013; 7: 241-249.

  3. Graivier M H, Bass L M, Lorenc Z P, Fitzgerald R, Goldberg D J, Lemperle G. Differentiating Nonpermanent Injectable Fillers: Prevention and Treatment of Filler Complications. Aesthet Surg J 2018; 38 (Spec Iss): S29-S40.

  4. Chiang Y Z, Pierone G, Al-Niaimi F. Dermal fillers: pathophysiology, prevention and treatment of complications. J Eur Acad Dermatol Venereol 2017; 31: 405-413.

  5. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 2013; 6: 295-316.

  6. Christensen L, Breiting V, Janssen M, Vuust J, Hogdall E. Adverse reactions to injectable soft tissue permanent fillers. Aesthetic Plast Surg 2005; 29: 34-48.

  7. Daines S M, Williams E F. Complications associated with injectable soft-tissue fillers a 5-year retrospective review. JAMA Facial Plast Surg 2013; 15: 226-231.

  8. Lowe N J, Maxwell C A, Patnaik R. Adverse reactions to dermal fillers: review. Dermatol Surg 2005; 31: 1616-1625.

  9. Alijotas-Reig J, Garcia-Gimenez V. Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature. J Eur Acad Dermatol Venereol 2008; 22: 150-161.

  10. Alcantara C E P, Noronha M S, Cunha J F, Flores I L, Mesquita R A. Granulomatous reaction to hyaluronic acid filler material in oral and perioral region: a case report and review of literature. J Cosmet Dermatol 2018; 17: 578-583.

  11. Ozturk C N, Li Y, Tung R, Parker L, Piliang M P, Zins J E. Complications following injection of soft-tissue fillers. Aesthet Surg J 2013; 33: 862-877.

  12. Tamiolakis P, Piperi E, Christopoulos P, Sklavounou-Andrikopoulou A. Oral foreign body granuloma to soft tissue fillers. Report of two cases and review of the literature. J Clin Exp Dent 2018; 10: e177-e184.

  13. Christensen L H. Host tissue interaction, fate, and risks of degradable and nondegradable gel fillers. Dermatol Surg 2009; 35 (Spec Iss): 1612-1619.

  14. Alijotas-Reig J, Fernandez-Figueras M T, Puig L. Late-onset inflammatory adverse reactions related to soft tissue filler injections. Clin Rev Allergy Immunol 2013; 45: 97-108.

  15. Glogau R G, Kane M A. Effect of injection techniques on the rate of local adverse events in patients implanted with nonanimal hyaluronic acid gel dermal fillers. Dermatol Surg 2008; 34 (Spec Iss): S105-S109.

  16. Urdiales-Galvez F, Delgado N E, Figueiredo V et al. Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations. Aesthetic Plast Surg 2018; 42: 498-510.

  17. Grippaudo F R, Di Girolamo M, Mattei M, Pucci E, Grippaudo C. Diagnosis and management of dermal filler complications in the perioral region. J Cosmet Laser Ther 2014; 16: 246-252.

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Syed A. Khurram.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Martin, L., Hankinson, P. & Khurram, S. Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers. Br Dent J 227, 281–284 (2019).

Download citation

  • Published:

  • Issue Date:

  • DOI:

Further reading


Quick links