Liquid vitamin E injection for cosmetic facial rejuvenation: A disaster report of lipogranuloma

Abstract

Using materials for cosmetic tissue augmentation may result in variable complications depending on the site of injection, injected material, the skill of the practitioner, and patient characteristics. 1,2 One of the most serious complications after cosmetic filler injections is related to untrained practitioners vs. injected material. 3 Lipogranuloma is an inflammatory condition that may occur after exogenous lipid or oil-like substances injection into the skin.Related lesions usually have round-to-ovoid, vacuole-like cavities with variable sizes in the dermis, which causes a Swiss cheese-like appearance. 4,5 Vitamin E is an oil-soluble vitamin that needs oil vehicles such as peanut oil or soya oil that are responsible for adverse effects caused by vitamin E injection. The most common adverse reactions related to vitamin E injection included lipogranuloma, sclerodermoid reaction, subcutaneous infiltration, subcutaneous nodules, persistent edema, deformation, and ulceration at the site of injection. 2,[4][5][6] Rarely, these reactions can extend and progress in an uncontrolled manner to life-threatening systemic conditions including hepatosplenomegaly, pulmonary fibrosis, 7 acute kidney injuries, disseminated lipogranuloma, and sudden death. 8 Herein, we report a 50-year-old woman who had a liquid vitamin E injection for cosmetic facial rejuvenation and development of