Foreign Body Removal Injection

What is it?

When unapproved substances such as paraffin or industrial silicone are injected into tissue, they can cause chronic inflammation and granulomas (hard lumps). Intralesional injections (steroids, etc.) can ease the inflammatory reaction and hardening, and if the injected substance is confirmed to be hyaluronic acid, a dissolving enzyme (hyaluronidase) can be used as well. However, foreign substances of unknown composition often don't disappear completely with injections alone, and for some lesions surgical removal is the standard approach.

Who it's for

• Hardness, lumps, inflammation or asymmetry at the site of an injected foreign substance
• Lesions that repeatedly swell up and settle down due to recurring inflammation
• Effects: reduced inflammation and hardening, improved shape — patients must be told the goal is "relief and improvement," not "complete removal"

Before treatment

• Consultation on the substance injected, when, and where (assuming that many patients won't know)
• If needed, ultrasound or similar imaging to check the extent and depth of the lesion
• Check allergy history; if an enzyme (hyaluronidase) will also be used, consider an allergy test beforehand
• A consultation to set realistic expectations is essential: multiple sessions are needed, complete removal may not be possible, and we'll discuss the possibility of referral for surgery

After treatment

• Don't rub or press on the treated area
• If swelling, warmth or pain gets worse, come in right away (to rule out infection)
• Avoid saunas and alcohol on the day of treatment
• Keep to the scheduled follow-up intervals (treatment proceeds step by step based on your response)

Good to know

• Pain, bruising and swelling at the injection site
• Temporary flare-up of inflammation; infection
• Steroid-related: skin thinning or indentation, lightening of skin color
• Because the substance is unknown, the response is hard to predict (the effect may be limited or absent)
• Rarely, allergic reactions

Pairs well with

• Combined with hyaluronidase (when the substance is suspected or confirmed to be HA)
• Lasers to improve scarring and texture once the lesion has settled (general approach)
• Large lesions or those that don't respond: referral for surgical removal (general approach)

"Treatment depends entirely on what was injected." "This isn't a procedure that pulls it all out at once; it calms things down step by step." "Complete removal may be difficult, and if needed, we'll guide you toward surgical options." "If inflammation keeps coming back, it's important not to leave it untreated."