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Granuloma Awareness: Understanding and Treatment OptionsHi, Dr. Sullivan! I’m sharing a case with a patient who was treated with silicone years ago and developed granulomas. Here’s what they look like: you’ll notice a firm bump like this one here. Granulomas often result from using non-HA fillers like silicone or PMMA.Why do granulomas form? 🤔 It’s the body’s reaction to permanent materials that it can’t eliminate, so it "walls them off" with a process called granuloma formation. Fillers like PMMA (e.g., Bellafill) are designed to reduce granuloma risk, but it can still happen—about 2-3% of patients in clinical trials. Silicone, especially if not FDA-approved, carries a much higher risk because it tends to trigger the immune system more aggressively.💡 Key takeaway: Think carefully about what you inject into your body. Materials matter when it comes to safety and side effects.Now, how do we treat granulomas?1️⃣ Kenalog: A powerful anti-inflammatory.2️⃣ 5-FU: An anti-metabolic agent to reduce granuloma formation.3️⃣ Physical disruption: I often use a no-core needle (commonly used for acne scarring) to break up the granuloma physically. It’s an effective method to treat and improve the condition.Granulomas are manageable, but prevention starts with informed decisions about fillers. Stay educated and cautious!

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