Complications related to filling the lips with hyaluronic acid for aesthetic purposes: an integrative review




Lip; Adverse effects; Hyaluronic acid.; Lip; Adverse effects; Hyaluronic acid.


Recently, with the advent of Orofacial Harmonization, there has been a great demand of people, mainly women, exhibiting in their social networks, or in the media in general, the aesthetic and rejuvenating treatments performed. Among the most chosen regions, the lips seem to be one of the most sought after. Thus, this integrative review aims to investigate the main complications related to filling the lips with Hyaluronic Acid (HA), for aesthetic purposes, and how they were treated. Articles from the last 10 years were selected, using the databases of the Virtual Health Library - BVS and PubMed, obtaining a sample of 107 publications of clinical cases that after applying the inclusion and exclusion criteria resulted in 08 articles that were included in this integrative review. After analyzing the articles included in the review, the results of the studies indicated that among the main complications are nodules or granulomas, understood as foreign bodies. In these cases, biopsy, most of the times excisional, was presented as a treatment procedure.


Alcântara, C. E. P., Noronha, M. S., Cunha, J. F., Flores, I. L., & Mesquita, R. A. (2018). Granulomatous reaction to hyaluronic acid filler material in oral and perioral region: A case report and review of literature. Journal of cosmetic dermatology, 17(4), 578-583.

Beer, K., Glogau, R. G., Dover, J. S., Shamban, A., Handiwala, L., Olin, J. T., & Bulley, B. (2015). A randomized, evaluator-blinded, controlled study of effectiveness and safety of small particle hyaluronic acid plus lidocaine for lip augmentation and perioral rhytides. Dermatologic Surgery, 41, S127-S136.

Caldas Pozuelo, C., Domínguez De Dios, J., & Mota Rojas, X. (2020). Multiple oral granulomatous nodules to hyaluronic acid filler. Journal of Cosmetic Dermatology, 19(12), 3453-3455.

Camerino, T. A., Fernandes, K. J. M., & Peixoto, F. B. (2019). Uso do ácido hialurônico para o rejuvenescimento da região dos lábios: Relato de Caso. Revista da Academia Brasileira de Odontologia, 8(2), 36-41.

Crossetti, M. D. G. O. (2012). Integrative review of nursing research: scientific rigor required. Revista gaucha de enfermagem, 33(2), 12-13.

Curi, M. M., Cardoso, C. L., Curra, C., Koga, D., & Benini, M. B. (2015). Late-onset adverse reactions related to hyaluronic acid dermal filler for aesthetic soft tissue augmentation. Journal of Craniofacial Surgery, 26(3), 782-784.

Dougherty, A. L., Rashid, R. M., & Bangert, C. A. (2011). Angioedema-type swelling and herpes simplex virus reactivation following hyaluronic acid injection for lip augmentation. Journal of the American Academy of Dermatology, 65(1), e21-e22.

Ercole, F. F., Melo, L. S. & Alcoforado, C. L. G. C. (2014). Revisão integrativa versus revisão sistemática. Revista Mineira de Enfermagem. 18(1), 9-12.

Farahani, S. S., Sexton, J., Stone, J. D., Quinn, K., & Woo, S. B. (2012). Lip nodules caused by hyaluronic acid filler injection: report of three cases. Head and neck pathology, 6(1), 16-20.

Feio, P. S. Q., Gouvêa, A. F., Jorge, J., & Lopes, M. A. (2013). Oral adverse reactions after injection of cosmetic fillers: report of three cases. International Journal of Oral and Maxillofacial Surgery, 42(4), 432–435.

Ganong, L.H. (1987) Integrative Review of Nursing Research. Research in Nursing & Health, 10, 1-11.

Goel, A., & Rai, K. (2021). Male lip filler—Aesthetic enhancement is not just limited to females: A case report. Journal of Cosmetic Dermatology, 00, 1-4.

Goulart, J. M., High, W. A., & Goldenberg, G. (2011). Evidence of calcium hydroxylapatite migration: distant nodule formation in the setting of concurrent injection with nonanimal stabilized hyaluronic acid. Journal of the American Academy of Dermatology, 65(2), e65-e66.

Hirsch, P., Infanger, M., & Kraus, A. (2020). A case of upper lip necrosis after cosmetic injection of hyaluronic acid soft‐tissue filler—Does capillary infarction play a role in the development of vascular compromise, and what are the implications? Journal of cosmetic dermatology, 19(6), 1316-1320.

Kalil, C. L. P. V., Caramori, A. P. A., Balkey, M. D., de Porto, C. H. S. C., & Caramori, A. P. Evaluation of the duration of injectable hyaluronic acid in nasolabial folds and perioral rhytids. Surgical Cosmetic Dermatology, 3(2), 112-115.

Rauso, R., Federico, F., Zerbinati, N., De Cicco, D., Nicoletti, G. F., & Tartaro, G. (2020). Hyaluronic Acid Injections to Correct Lips Deformity Following Surgical Removal of Permanent Implant. Journal of Craniofacial Surgery, 31(6), e604-e606.

Rivers, J. K., & Mistry, B. D. (2018). Soft-tissue infection caused by streptococcus anginosus after intramucosal hyaluronidase injection: a rare complication related to dermal filler injection. Dermatologic Surgery, 44, S51-S53.

Sahan, A., & Funda, T. (2018). Four-point injection technique for lip augmentation. Acta Dermatovenerol Alp Pannonica Adriat, 27(2), 71-73.

Sarnoff, D. S., & Gotkin, R. H. (2012). Six steps to the" perfect" lip. Journal of drugs in dermatology: JDD, 11(9), 1081-1088.

Scarano, A., Puglia, F., Cassese, R., Mordente, I., Amore, R., Ferraro, G., Sbarbati, A., Russo, F. L., Lucchina, A. G., & Amuso, D. (2019). Hyaluronic acid fillers in lip augmentation procedure: a clinical and histological study. Journal of biological regulators and homeostatic agents, 33(6 Suppl. 2), 103-108.

Souza, M. T. D., Silva, M. D. D., & Carvalho, R. D. (2010). Integrative review: what is it? How to do it? Einstein (São Paulo), 8, 102-106.

Urdiales-Gálvez, F., Delgado, N. E., Figueiredo, V., Lajo-Plaza, J. V., Mira, M., Moreno, A., Ortíz-Martí, F., Rio-Reyes, R., Romero-Álvarez, N., Cueto, S.R., Segurado, M. A., & Rebenaque, C. V. (2018). Treatment of soft tissue filler complications: expert consensus recommendations. Aesthetic plastic surgery, 42(2), 498-510.

Vargas, A. F., Amorim N. G., & Pintaguy, I. (2009). Complicações tardias dos preenchimentos permanentes. Revista Brasileira de Cirurgia Plástica, 24(1), 71-81.

Vidič, M., & Bartenjev, I. (2018). An adverse reaction after hyaluronic acid filler application: a case report. Acta Dermatovenerologica Alpina, Pannonica, et Adriatica, 27(3), 165-167.

Yazdanparast, T., Samadi, A., Hasanzadeh, H., Nasrollahi, S. A., Firooz, A., & Kashani, M. N. (2017). Assessment of the efficacy and safety of hyaluronic acid gel injection in the restoration of fullness of the upper lips. Journal of cutaneous and aesthetic surgery, 10(2), 101.

Zhang, F. F., Xu, Z. X., & Chen, Y. (2020). Delayed Foreign Body Granulomas in the Orofacial Region after Hyaluronic Acid Injection. Chin J Dent Res, 23(4), 289-296.



How to Cite

ESCOBAR, M. V. S. C.; NEVES, I. S. R. das; OLIVEIRA, E. R. M. de .; SOUZA, V. J. S. de; SANTIAGO, A. P. de A. da C. e S. Complications related to filling the lips with hyaluronic acid for aesthetic purposes: an integrative review. Research, Society and Development, [S. l.], v. 10, n. 14, p. e569101422259, 2021. DOI: 10.33448/rsd-v10i14.22259. Disponível em: Acesso em: 14 jul. 2024.



Health Sciences