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Adjuvant Use of a 1,064 nm Neodymium-doped Yttrium Aluminum Garnet Laser for the Management of Refractory Late-Onset Nodules Related to Polymethylmethacrylate Fillers.

Although hyaluronic acid filler use predominates in aesthetic medicine, semipermanent fillers for softtissue augmentation have been available for more than 20 years. Delayed-onset nodules from injected polymethylmethacrylate (PMMA) dermal fillers present as subcutaneous nodules that may develop months to years after the initial procedure. This complication may occur in up to 2% of patients having received PMMA containing dermal fillers. Foreign body reactions, biofilm, and inflammation are thought to play a role in nodule development, and therefore several treatments including antibiotics, intralesional triamcinolone/5-fluorouracil, or systemic corticosteroids have been used. Herein, we report clinical findings on 7 patients who presented with refractory delayed-onset nodules related to PMMA fillers and were treated with a long-pulsed 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser.