[Macrolane®: A severe case of calf cellulitis after modeling injection]

Area of Science:

• Plastic surgery
• Dermatology
• Medical device regulation

Background:

• The market for resorbable injectables, such as hyaluronic acid fillers, is growing.
• These products are regulated as medical devices, not pharmaceuticals, facilitating market access.
• Macrolane, a non-animal stabilized hyaluronic acid (NASHA) gel, has been available since 2007 and is approved for use outside the face.

Observation:

• Macrolane is highly cross-linked, potentially leading to persistent residues in the body.
• The case involved an injection into the calf performed in a clinical setting.
• This led to the development of cellulitis, an inflammation of the skin and underlying tissue.

Findings:

• This case represents the first documented instance of cellulitis occurring after Macrolane injection into the calf.
• The high cross-linking of the hyaluronic acid may contribute to its longevity and potential for complications.
• Cellulitis is a significant adverse event that can arise from such procedures.

Implications:

• The findings underscore the importance of monitoring for adverse events associated with resorbable injectables.
• Further research may be needed to fully understand the long-term risks and safety profile of highly cross-linked hyaluronic acid fillers.
• This case highlights the need for vigilance among practitioners regarding potential complications of aesthetic medical devices.