An Unusual and Delayed Complication of Hyaluronic Acid Filler Injection: A Case Report

Hyaluronic acid (HA) fillers are widely utilized in aesthetic dermatology for facial rejuvenation due to their safety and efficacy. However, delayed complications, although rare, may pose diagnostic and therapeutic challenges. We present a case of a 42-year-old female who developed a painful inflammatory nodule six months after receiving HA filler injections in the nasolabial fold. Initial conservative treatment with antibiotics and nonsteroidal anti-inflammatory drugs was ineffective. Definitive resolution was achieved following intralesional corticosteroid and hyaluronidase injections, which degraded the filler and reduced inflammation. Ultrasound imaging confirmed the presence of a well-defined subcutaneous lesion without systemic infection. This case underscores the importance of recognizing delayed inflammatory reactions to HA fillers and adopting appropriate stepwise management strategies. Early diagnosis and combined therapeutic approaches can improve patient outcomes and minimize morbidity associated with such rare complications.