Angioedema and lip filler: 4 years-same patient case report and literature analysis
Keywords:
hyaluronic acid (HA) fillers, recurrent angioedema, nickel allergy, aesthetic procedure complicationsAbstract
Background: Hyaluronic acid (HA) fillers are widely used in aesthetic medicine for minimally invasive facial enhancement due to their favorable safety profile. However, rare but potentially significant adverse reactions such as angioedema can occur, with clinical and therapeutic implications.
Objective: To describe a case of repeat angioedema following repeated HA lip filler sessions in a patient with nickel hypersensitivity, and to review current evidence regarding pathophysiology, risk factors, and management strategies.
Case Report: A 53-year-old woman with a history of nickel allergy presented recurrent episodes of localized angioedema after several lip filler procedures performed by different clinicians, each involving various HA products and injection techniques. Despite premedication with corticosteroids in later sessions, angioedema recurred variably, with laboratory testing excluding hereditary forms. The potential contribution of nickel exposure from the needles, procedural factors, and the underlying allergy was considered.
Discussion: Angioedema is a rare but clinically relevant complication of HA fillers, particularly in patients with allergic predisposition. Comprehensive pre-procedural screening, patient education, and prompt management protocols are essential. Current literature supports the overall safety of HA fillers, though practitioners should remain vigilant for immune-mediated responses, especially when performing procedures in at-risk individuals.
Conclusion: This report presents, to our knowledge, the only documented case of recurrent angioedema after hyaluronic acid lip filler in a nickel-allergic patient, with extended follow-up across multiple procedures and practitioners. Our findings provide novel insight into this rare association, emphasizing the importance of thorough allergy screening and multidisciplinary management in aesthetic practice.
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