Abstract
We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of cases of foreign body granuloma (FBG) induced by hyaluronic acid (HA). A total of 27 patients with HA filler-induced FBG reported in literature were included. The estimated incidence of HA-induced FBG is 0.02%-0.6%. Several factors are involved, including cross-linking agents and impurities. The most frequent clinical presentation is asymptomatic nodules, although other lesions may occur. Histopathological examination is the gold standard for diagnosis, but ultrasound is a promising tool. Treatment options include expectant management, hyaluronidase, corticosteroids, 5-fluorouracil, and surgery.