• Archives of Plastic Surgery
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• v.38 no.6
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• pp.875-878
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• 2011

Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.69-76
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• 1997

To exanime in vivo tissue reactions of glass fibers, we injected glass fibers to rats subcutaneously. We made fibers of average dimensions of approximately $2{\mu}m$ in diameter and $60{\mu}m$ in length. After instilation of glass fiber we sacrificed rats sequentially at 1, 3 and 6 months. At 1 month after injection of glass fibers, the exposure area turned to yellow color and formed well-demarcated round mass. The average size of the mass was $1\times0.3cm$. Grossly detectable mass was decreased in size at 6 months compared to 1 or 3 months. Microscopically, strong foreign body reaction to glass fibers, inflammation and fibrosis were observed until 6 months. Foreign body reaction was increased up to 3 months, but it was decreased after 6 months. In scanning electron microscope, there was many bundles of glass fibers around the inflammation area, but the size of glass fibers were gradually reduced from 1 month to 6 months. These results suggest that subcutaneous exposure of glass fiber can provoke strong tissue reaction including foreign body granulomas, inflammation and fibrosis. But glass fiber itself did not produce any neoplastic changes.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.40-45
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• 2016

Background Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws. Methods A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla. Results Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction. Conclusions Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.59-62
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• 2013

There are various types of foreign body reactions, such as inflammation, edema, fluid collection, hematoma, infection, abscess and granulomas. There are various imaging findings according to types of foreign bodies and depending on the lapse of time. Therefore, correct diagnosis of a foreign body reaction is difficult and easily confused with soft tissue neoplasm. The MRI is ideal for the detection of foreign bodies regardless of radiolucency or acoustic impedance. It is especially very useful in the evaluation of the surrounding tissue reaction. The authors report a case of a 26-year-old female patient with both forearm swelling due to self-injection of a mixture of powdered tablets and saline. The lesion shows numerous internal T1 and T2 dark signal intensity micro-spots with surrounding fluid collection, which are diagnosed as foreign bodies with surrounding inflammatory changes during an operation.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.164-167
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• 1995

Foreign holies in the upper aerodigestive tract are an important cause of morbity and mortality in older adults and children under 3 years of age. Fish and chicken bones are the usual foreign bodies lodged in the hypopharynx, and most of them lodge In the lower pole of a tonsil, at the base of the tongue, at the lateral wall of the pharynx, or in a vallecula. Recently, the authors experienced a case of aspiration pneumonia caused by chronic local inflammatory reaction of the posterior wall of the hypopharynx originated from a special foreign body.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.163-172
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• 2011

Subcutaneous foreign body causes recurrent problems such as chronic soft tissue swelling and discharge. Wooden foreign body is one of the most common foreign bodies found in subcutaneous region including face, interdigit, and thoracic or abdominal area. This report demonstrated three dogs with wooden foreign body located in subcutaneous region of thoracic wall, abdominal wall and upper eyelid, respectively. Three dogs showed prominent soft tissue swelling adjacent the foreign body. A sinus or drainage tract was developed in two of these dogs. Ultrasonography revealed that hyperechoic linear structure accompanied acoustic shadow in all dogs, and which was diagnosed as a subcutaneous foreign body. Anechoic or hyperechoic fluid and hypoechoic tissue circumscribed the foreign body. A subcutaneous foreign body in case 3 was removed by clamp under ultrasound-guide with sedation. Sinography was performed in case 1 and clarified that the wooden foreign body did not perforate the thoracic wall and there was no direct communication into thoracic cavity. Ultrasonography and sinography can be used to identify the subcutaneous foreign body and evaluate the inflammatory reaction and relationship between foreign body and adjacent structures.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.232-239
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• 2015

A foreign body granuloma is a non-allergic chronic inflammatory reaction that is mainly composed of multinucleated giant cells. Foreign body granulomas may occur after the administration of any dermal filler. Factors such as the volume of the injection, impurities present in the fillers, and the physical properties of fillers affect granuloma formation. The formation of granulomas involves five phases: protein adsorption, macrophage adhesion, macrophage fusion, and crosstalk. The clinical and pathologic features of granulomas vary depending on the type of filler that causes them. Foreign body granulomas can be treated effectively with intralesional corticosteroid injections. Surgical excisions of granulomas tend to be incomplete because granulomas have ill-defined borders and moreover, surgical excisions may leave scars and deformities.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.611-614
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• 2008

Purpose: Infection, foreign body reaction and decreased volume of implant are common complications after augmentation rhinoplasty with $Gore-tex^{(R)}$ implant. The author experienced two cases of recurrent foreign body granuloma in the patients who underwent $Gore-tex^{(R)}$ removal because of infection after augmentation rhinoplasty. and treated them with complete removal of$Gore-tex^{(R)}$. Methods: Case 1: A 49 year-old female visited our clinic for recurrent foreign body reaction on nasal dorsum and tip area. The patient underwent augmentation rhinoplasty with $Gore-tex^{(R)}$ 3 years ago and implant was removed due to infection 9 months ago. Excision of the granuloma was performed and a piece of foreign body suspicious to be a $Gore-tex^{(R)}$ implant debris was detected under the subcutaneous pocket. The implant fragments were removed and nasalis muscle rotation flap was performed to cover the lesion. The specimen was proved to be $Gore-tex^{(R)}$ in histological study. Case 2: A 31 year-old-male with recurrent foreign body granuloma on the nasal tip area visited our clinic. 10 years ago, the patient had augmentation rhinoplasty with silicone implant and then, he underwent revisional rhinoplasty five times including nasal implant removal, which was performed 9 months ago. The authors excised the granuloma and found a small sized foreign body suspicious to be a $Gore-tex^{(R)}$ implant debris under the granuloma. The foreign body was excised and identified to be $Gore-tex^{(R)}$ in histological study. Results: In both cases, the lesions were healed without any complications and there were no evidences of recurrence up to 6 months of follow-up. Conclusion: The $Gore-tex^{(R)}$ is known to be weak against mechanical force. These properties of $Gore-tex^{(R)}$ make it difficult to remove the implant completely. In the patient who have infection after augmentation rhinoplasty with $Gore-tex^{(R)}$, the operator should take care to perform the complete removal without remaining fragment of the implant.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.20-26
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• 2024

The etiology and pathophysiology of delayed inflammatory reactions caused by hyaluronic acid fillers have not yet been elucidated. Previous studies have suggested that the etiology can be attributed to the hyaluronic acid filler itself, patient's immunological status, infection, and injection technique. Hyaluronic acid fillers are composed of high-molecular weight hyaluronic acids that are chemically cross-linked using substances such as 1,4-butanediol diglycidyl ether (BDDE). The mechanism by which BDDE cross-links the two hyaluronic acid disaccharides is still unclear and it may exist as a fully reacted cross-linker, pendant cross-linker, deactivated cross-linker, and residual cross-linker. The hyaluronic acid filler also contains impurities such as silicone oil and aluminum during the manufacturing process. Impurities can induce a foreign body reaction when the hyaluronic acid filler is injected into the body. Aseptic hyaluronic acid filler injections should be performed while considering the possibility of biofilm formation or delayed inflammatory reaction. Delayed inflammatory reactions tend to occur when patients experience flu-like illnesses; thus, the patient's immunological status plays an important role in delayed inflammatory reactions. Large-bolus hyaluronic acid filler injections can induce foreign body reactions and carry a relatively high risk of granuloma formation.

• Investigative Magnetic Resonance Imaging
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• v.19 no.2
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• pp.127-130
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• 2015

Direct injection of foreign material, such as liquid paraffin and silicone, into the breast can induce a foreign body granulomatous reaction and fibrosis, resulting in hard, nodular breast masses and architectural distortion that can mimic neoplasm. Conventional methods, including physical examination, mammography, and ultrasonography are of little use to differentiate between foreign body-induced mastopathy and breast cancer. In patients with foreign body injection such as breast augmentation, dynamic contrast enhanced MR imaging is an excellent imaging modality. Here, the authors report the MR imaging and pathological findings of ductal carcinoma in situ (DCIS) with multicystic changes in a 41-year-old woman with a previous history of interstitial mammoplasty by paraffin injection.