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Foreign Body Reaction to Radiesse: 2 Cases

Moulonguet, Isabelle MD*; Arnaud, Eric MD; Bui, Patrick MD; Plantier, Françoise MD*

The American Journal of Dermatopathology: May 2013 - Volume 35 - Issue 3 - p e37–e40
doi: 10.1097/DAD.0b013e3182732324
Extraordinary Case Report

Abstract: We report 2 cases of a foreign body reaction to Radiesse, a semipermanent soft-tissue filler consisting of 30% calcium hydroxylapatite microspheres and 70% carboxymethyl cellulose gel carrier. In one case, injection of this filler provoked a nodule on the columella, which was discovered during rhinoplasty. In the second case, the reaction was revealed during histopathologic examination of the deep section of a surgically removed basal-cell carcinoma. Histopathology showed a foreign body reaction with numerous giant cells and histiocytes, some plasma cells, and lymphocytes. Within this inflammatory reaction, a nonpolarizing exogenous material was identified consisting of numerous, round, uniformly sized, yellowish, extracellular deposits with a crackled appearance. Although many authors claim that Radiesse does not induce any foreign body reactions, we found a number of similar histopathologic pictures in studies describing animal or human auricular area test sites or even in reports of lip nodules, which are a well-known adverse effect after injection of this filler into this site. The histopathologic appearance of Radiesse is particularly distinctive and easily recognizable by dermatologists and dermatopathologists.

*Cabinet de Dermatopathologie

Cabinet de Chirurgie Plastique, Paris, France.

Reprints: Isabelle Moulonguet, MD, Cabinet de Dermatopathologie, 35, Avenue Mathurin Moreau, Paris 75019, France (e-mail:

The authors have no funding or conflicts of interest to declare.

© 2013 by Lippincott Williams & Wilkins.