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Periorbital lipogranuloma: a previously unknown complication of autologous fat injections for facial augmentation
  1. Ho-Seok Sa1,
  2. Kyung In Woo2,
  3. Yeon-Lim Suh3,
  4. Yoon-Duck Kim2
  1. 1Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
  2. 2Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  3. 3Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  1. Correspondence to Dr Yoon-Duck Kim, Department of Ophthalmology, Samsung Medical Center, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea; ydkimoph{at}


Background Autologous fat injection into the face is a commonly used technique in plastic surgery. Autologous fat is claimed to be a safe soft-tissue filler without a foreign body reaction. This article reports on several cases of periorbital lipogranuloma after autologous fat injection for facial augmentation.

Methods This was a retrospective, non-comparative and interventional case series. The authors identified nine patients with periorbital lipogranuloma. All patients had a history of previous autologous fat injection into the face by different plastic surgeons. A medical record review was performed for clinical history, radiological and histopathological studies, and treatment.

Results Nine patients developed periorbital granuloma after autologous fat injection for facial augmentation. Eight of the patients had received two injections of autologous fat, and seven patients had undergone a second injection with their cryopreserved fat tissue. Erythematous swelling of the upper eyelid was refractory to antibiotic and steroid treatment, and surgery was required to resolve the inflammatory reactions in six cases. Histopathological evaluation revealed features of a lipogranulomatous reaction, with collection of histiocytes and foreign-body type giant cells around variable-sized microcysts containing lipid materials.

Conclusions Lipogranuloma can develop in the eyelid following autologous fat injection to the forehead or glabella. Clinicians should be aware of this potential complication of a granulomatous reaction following autologous fat injection. Techniques for the injection and preservation of autologous fat should be refined.

  • Autologous fat injection
  • cryopreservation
  • lipogranuloma
  • eye lids
  • pathology
  • inflammation

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  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board (IRB)/Ethics Committee at Samsung Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.