Clinical outcome in a series of 173 cases of foreign body granuloma: improved outcomes with a novel surgical technique.

[BACKGROUND] Soft-tissue filler injections have become popular, and injections of even illegal materials are widespread. Complications such as foreign body granuloma often occur in such cases, and appropriate treatment is mandatory but no optimal treatment has been established.

[METHODS] We treated 173 patients who underwent surgical excision of foreign body granulomas via direct approach to the lesion (n = 121) or injection therapies (n = 52) at Kangbuk Samsung Hospital over a period of 7 years from April 2004 to February 2011. A retrospective chart review found that 104 patients had a history of treatment failure at other hospitals. Among these 104 patients, 83 had a history of prior injection therapy and 21 patients had a history of prior surgical therapy. Patient satisfaction was evaluated at our hospital on a scale of 1-5 using an in-house questionnaire. Comparisons between patients receiving injection therapy and patients receiving surgical therapy were made using the Mann-Whitney test.

[RESULTS] Patients who underwent surgical therapy via direct approach to the lesion reported statistically higher satisfaction scores 4(3-4) than those who underwent injection therapy 3(2-3) (p < 0.001).

[CONCLUSIONS] Our novel surgical technique results in better outcomes and patient satisfaction in cases of severe foreign body granuloma.