ABSTRACT In recent years, there has been an unprecedented increase in the number of injection contour plasty (ICP) procedures aimed at rejuvenation or correction of aesthetic facial defects. In the case of the correct choice of medicinal products, indications, and compliance with procedures, the result of correction is aesthetically significant and prolonged and rehabilitation period is short. Despite the fact that, according to manufacturers, dermal fillers are safe, their injection may cause adverse reactions and complications. A doctor should be fully competent in this area in order to avoid adverse effects and provide an adequate treatment. The article reports a case of a non-standard complication after facial filler injection. We discuss key points of diagnosis and treatment of this type of patients. These complications after ICP may be caused by non-compliance with the principles of asepsis and antiseptic during manipulations, infected gel, or the presence of somatic chronic infectious pathology. This case is not the only one in aesthetic practice. ICP associated with injection of filler (and, in fact, a foreign body) can trigger activation of chronic smoldering inflammation in the form of an acute process with circulation of microorganisms in the bloodstream. As a result, chronic inflammation (especially dentitional one) causes development of bacteremia resistant to standard complex treatments followed by a torpid infection, which exacerbates during surgical manipulation (in this case, ICP). It was shown that, when planning ICP, special attention should be paid to the presence of somatic pathology, including foci of chronic infection, and manipulations should comply with aseptic and antiseptic principles. In cases of the development of inflammatory process and ineffectiveness of conventional complex treatment, additional highly informative clinical and laboratory methods are required to assess patient’s immune status, diagnose the presence of microorganisms in the bloodstream, and prescribe individually optimized therapy.
