Lip filler-related granulomatous inflammation mimicking oral pathology: A case report

Injectable dermal fillers are widely used in esthetic practice for lip augmentation and perioral soft-tissue enhancement. Although delayed complications such as foreign-body reactions and filler migration are described in the dermatologic literature, their manifestation as oral lesions during routine dental examination is less commonly recognized.

A 67-year-old woman had multiple firm, white, elevated nodules on the right lower labial mucosa approximately 1 month after receiving injectable dermal filler in the lip. The lesions were nonmobile, with intact overlying mucosa and no ulceration, and the patient was concerned about possible malignancy. Because a neoplastic process could not be excluded clinically, excisional biopsy was performed for diagnostic and therapeutic purposes. Intraoperatively, firm, white deposits consistent with migrated filler material were identified. Superficial material was removed and submitted for histopathologic examination, whereas deeper deposits were intentionally left in place to avoid injury to adjacent neurovascular structures. Histopathologic evaluation showed chronic granulomatous foreign-body reaction to exogenous material without dysplasia or malignancy. At 6 weeks, the patient reported persistent sensitivity without objective paresthesia and was treated with a short course of methylprednisolone. At 6 months, no clinically detectable filler material remained, and symptoms had resolved.

Complications associated with injectable dermal fillers may manifest as labial lesions that mimic primary oral pathology. Dentists should obtain a complete history of prior esthetic procedures when evaluating unexplained perioral or labial lesions. Appropriate surgical management and histopathologic confirmation are important when the diagnosis is uncertain.