Relationship Between Delayed Reactions to Dermal Fillers and Biofilms: Facts and Considerations

BACKGROUNDDelayed reactions associated with dermal fillers have often been attributed to hypersensitivity reactions; however, the evolving literature suggests that biofilms may represent an underrecognized cause and a difficult diagnosis to establish. As implanted devices become more popular, biofilms present an increasing risk to patients.OBJECTIVEThe mechanism of action for biofilm formation, diagnostic challenges, and methods to recognize biofilms will be reviewed. These are increasingly important for physicians who implant these devices and for those who see patients with implanted devices.METHODSWe review the relevant literature and explore some of these issues.CONCLUSIONPreventative measures may decrease delayed reactions and biofilm formation after injection of dermal fillers. Infection through biofilms should be considered and carefully evaluated to ensure timely treatment.