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Cheng WJ, Cai ZX, Tang XJ. Adverse reactions to cosmetic implants after COVID-19 vaccination: A literature review. J Cosmet Dermatol 2023; 22:3199-3212. [PMID: 37592436 DOI: 10.1111/jocd.15828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/08/2023] [Accepted: 05/09/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND As the world's population of people vaccinated with the COVID-19 vaccine increases, adverse reactions are increasingly being reported. There have been progressive reports of the effects of COVID-19 vaccination on cosmetic fillers or prostheses, but they have not been reviewed based on their clinical morphologic patterns. This article reviewed the progress of research on adverse reactions to cosmetic implants after COVID-19 vaccination. METHODS We researched the English-language literature up to October 15, 2022, using predefined keywords to identify relevant studies about adverse reactions to cosmetic implants after the COVID-19 vaccination, collecting patient characteristics, implant type, the time interval between vaccination and implantation or injection, time of onset, symptoms, treatments, and outcomes. RESULTS Among the adverse reactions to implants associated with COVID-19 vaccination, we distinguished between (1) injectable fillers and (2) surgical prosthetic implants. The most common adverse reactions were at the site of hyaluronic acid injection and breast prosthesis after Pfizer vaccination, mainly DIRs, and mainly manifested as edema, rash, fever, and capsular contracture. This paper also reported the possible causes, treatments of DIRs, and limitations of current studies. CONCLUSIONS In this article, we attempted to investigate and discuss all the adverse reactions of cosmetic implants related to COVID-19 vaccination in the current literature, to unmask these reactions and make a more accurate assessment of vaccine safety.
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Affiliation(s)
- Wen-Jie Cheng
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zi-Xing Cai
- Xiamen University Medical College, Fujian, China
| | - Xiao-Jun Tang
- Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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Berrino V, Berrino P. Lower Eyelid Complication After Blepharoplasty and COVID-19 Vaccination. Aesthetic Plast Surg 2023; 47:2573-2578. [PMID: 37580564 DOI: 10.1007/s00266-023-03532-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/17/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Following COVID-19 mass vaccination campaign, new- and unknown-related reactions have emerged. CASE REPORT Four months after transcutaneous lower blepharoplasty and few days after the second dose of SARS-CoV-2 Pfizer mRNA vaccination, a 57-year-old man developed a bilateral palpebral ecchymosis. While the lesion healed spontaneously on the left side, the ecchymosis on the right lower lid did not regress. It presented swelling and hard consistency, clinically involving only skin layer. No alterations were revealed upon blood tests and instrumental evaluations. Histological examination showed lymphovascular hyperplasia on a probable reactive basis. The lesion was resistant to medical and surgical therapies. After 15 months, it regressed spontaneously. CONCLUSIONS In the reported case, an evident chronological relationship exists between surgical site and vaccine reaction, while other etiopathogenetic factors were excluded. This case represents a previously undescribed condition linking postvaccination reaction and long-term surgical outcome. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Valeria Berrino
- Chirurgia Plastica Genova Srl, Via A.M. Maragliano 2, 16121, Genoa, Italy.
| | - Pietro Berrino
- Chirurgia Plastica Genova Srl, Via A.M. Maragliano 2, 16121, Genoa, Italy
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Berger LE, Spoer DL, Bovill JD, Huffman SS, Bell AC, Truong BN, Singh A, Fan KL, Tom LK. COVID-19 Vaccination Status and Capsular Contracture Following Prosthetic Breast Reconstruction: A Retrospective, Multicenter Nested Case-Control Study. Aesthet Surg J 2023; 43:NP170-NP180. [PMID: 36395159 DOI: 10.1093/asj/sjac295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Capsular contracture (CC) is a common long-term complication following prosthetic-based breast reconstruction (PBBR). Seven cases of CC following mRNA vaccination for coronavirus 2019 (COVID-19) are reported in the literature. OBJECTIVES The aim of this study was to determine whether receiving the COVID-19 vaccine was associated with CC development following PBBR. METHODS A retrospective, multicenter nested case-control study was performed from January 2014 to July 2022 of adult female patients who underwent PBBR with acellular dermal matrix placement. Cases of CC were selected if no adjuvant radiation was received and they presented for follow-up between December 2020 and July 2022. Controls included patients who met inclusion criteria but who did not experience CC in either breast. Patient demographics, breast cancer characteristics, reconstructive surgery details, postoperative complications, and COVID-19 exposure details were analyzed and correlated with CC development. RESULTS Of a total of 230 patients (393 breasts) who received PBBR, 85 patients (135 breasts) met inclusion criteria, of whom 12 patients (19 breasts) developed CC and 73 patients (116 breasts) did not. At the time of median follow-up of 18.1 months (n = 85; interquartile range, 12.2-33.6 months), no statistically significant differences were observed between the short- or long-term complications in cases or controls. There were no significant differences in COVID-19 vaccination status, number of vaccine doses, or vaccination type between cases and controls. Vaccination status was not associated with greater odds of CC development (odds ratio, 1.44; 95% CI, 0.42-5.37; P > .05). CONCLUSIONS Direct association between CC and COVID-19 vaccination is difficult to prove. Given the known risk of severe COVID-19 infection among immunocompromised patients, those with breast cancer who undergo PBBR should be properly counseled on the benefits and risks of vaccination. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Lauren E Berger
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Daisy L Spoer
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - John D Bovill
- Georgetown University School of Medicine, Washington, DC, USA
| | - Samuel S Huffman
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Alice C Bell
- Georgetown University School of Medicine, Washington, DC, USA
| | - Brian N Truong
- Georgetown University School of Medicine, Washington, DC, USA
| | - Anusha Singh
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Kenneth L Fan
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Laura K Tom
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
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4
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Chan SLS, Hsieh MKH, Mok JWL, Kong TY. Delayed prosthetic seroma: a localized inflammatory response to COVID vaccination and infection? EUROPEAN JOURNAL OF PLASTIC SURGERY 2023; 46:125-128. [PMID: 36624820 PMCID: PMC9813890 DOI: 10.1007/s00238-022-02031-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023]
Abstract
We present a patient whom we believe developed a late abdominal mesh collection in response to COVID-19 mRNA vaccination booster and COVID-19 infection. A polypropylene mesh was placed during her right breast reconstruction operation 2 years ago where she underwent a right transverse abdominis rectus muscle (TRAM) free flap. She recovered uneventfully from this operation. This lady, though vaccinated, developed respiratory symptoms and tested positive for COVID-19 infection 3 days after her booster injection. She then noticed right-sided abdominal swelling 3 days after the onset of respiratory symptoms. She only presented 1 month later due to a 7-day history of pain at the site of abdominal swelling. A computed tomography scan confirmed the presence of a seroma, and she underwent ultrasound-guided percutaneous drainage. A COVID Antigen Rapid Test of the fluid returned positive, though the PCR swab returned negative. There have been no published reports of periprosthetic mesh seroma after COVID-19 vaccination or infection to date. We wanted to share our experience so that other surgeons may be aware of this potential presentation given the current ongoing pandemic. Level of evidence: Level V, risk/prognostic.
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Affiliation(s)
- Stephanie Li-shan Chan
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - Michael Ku Hung Hsieh
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - James Wan Loong Mok
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
| | - Tze Yean Kong
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Women’s Tower, 100 Bukit Timah Road, 229899 Singapore, Singapore
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Chan SLS, Mok JWL. Late Seroma in Breast Implants: A Coronavirus Disease 2019 Phenomenon? Arch Plast Surg 2022; 49:611-613. [PMID: 36159375 PMCID: PMC9507605 DOI: 10.1055/s-0042-1756295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 07/07/2022] [Indexed: 10/31/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been challenging in all aspects of the medical field with new clinical presentations constantly arising. Plastic surgeons are not immune to this and need to be aware of their implications. There has been a recent report of late periprosthetic seroma (breast implant) as a clinical manifestation of COVID-19 infection. To our knowledge, this phenomenon has not been further reported. We present a 53-year-old immunocompromised lady who developed late seroma after COVID-19 infection. She eventually required explantation of the implant and is awaiting autologous reconstruction. It is likely that we will increasingly continue to see this phenomenon of implant complications as a result of COVID-19 infection and should be watchful, especially regarding potential immunocompromised patients.
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Affiliation(s)
- Stephanie L S Chan
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore
| | - James Wan Loong Mok
- Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore
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[Translated article] COVID-19 and Dermal Fillers: Should We Really Be Concerned? ACTAS DERMO-SIFILIOGRAFICAS 2022. [PMID: 35952917 PMCID: PMC9359628 DOI: 10.1016/j.ad.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SARS-CoV-2 has caused millions of infections and deaths worldwide and case numbers continue to rise. Besides the effect of the virus on key organs – leading to respiratory illness, anosmia, diarrhea, and fever and other complications – delayed inflammatory reactions to hyaluronic acid dermal fillers, mainly in the face, have also been reported to occur after confirmed SARS-CoV-2 infections and in vaccinated individuals. While delayed inflammatory reactions tend to be self-limiting, they should be diagnosed and treated with corticosteroids, hyaluronidase, and/or antibiotics when necessary. The inflammation is generally not severe, yet these complications are classified as serious adverse events by the US Food and Drug Administration. They appear to be delayed type IV hypersensitivity reactions triggered by the immune system in the presence of SARS-CoV-2 or other viruses, such as those causing influenza, although the underlying mechanisms have not been fully elucidated. Because the longevity of dermal fillers is increasing, while the pandemic continues to evolve and new vaccines are under development, the long-term effects on hyaluronic acid fillers and other bioimplant materials should be studied. Physicians must also be encouraged to report these reactions, however mild, to ensure accurate records.
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Weitgasser L, Mahrhofer M, Schoeller T. Commentary on “Late seroma of the breast in association with COVID-19 infection: two case reports”. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022; 45:689-690. [PMID: 35694001 PMCID: PMC9168348 DOI: 10.1007/s00238-022-01972-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Laurenz Weitgasser
- Department of Plastic and XReconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Boeheimstr 37, 70199 Stuttgart, Germany
| | - Maximilian Mahrhofer
- Department of Plastic and XReconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Boeheimstr 37, 70199 Stuttgart, Germany
| | - Thomas Schoeller
- Department of Plastic and XReconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Boeheimstr 37, 70199 Stuttgart, Germany
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COVID y rellenos faciales ¿realmente debemos preocuparnos? ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:888-894. [PMID: 35659611 PMCID: PMC9159960 DOI: 10.1016/j.ad.2022.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/01/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022] Open
Abstract
La pandemia por COVID ha causado hoy en día millones de afectados, continuando su aumento a nivel mundial. Junto con la afectación los órganos diana clave (aparato respiratorio, anosmia, diarrea, fiebre, etc.), se han descrito reacciones inmunológicas tardías en los rellenos dérmicos por ácido hialurónico (AH), fundamentalmente a nivel facial. Estas alteraciones aparecen tanto en pacientes positivos para el virus, independientemente de la sintomatología sistémica, como en pacientes que han recibido vacunación frente al SARS-CoV-2. Aunque las reacciones suelen ser autolimitadas y autoresolutivas, es importante saber diagnosticarlas y en ocasiones establecer tratamiento con corticoides, hialuronidasa y/o antibióticos. Aunque no son graves, la Administración de Alimentos y Medicamentos de los Estados Unidos (FDA) las ha clasificado como evento adverso serio. Los mecanismos que originan están reacciones no están completamente dilucidados. Parece que son reacciones de hipersensibilidad retardada tipo IV, favorecidas por estímulos inmunológicos que se activan en presencia de la COVID o de otros virus como la gripe. Sin embargo, dado que los rellenos presentan cada vez mayor durabilidad y a que la pandemia continúa su curso, existiendo nuevas vacunas en desarrollo, es esencial la realización de estudios que describan la evolución a largo plazo tanto de los rellenos de AH, como de otros bioimplantes. Así mismo, es esencial alentar a los médicos de que reporten este tipo de reacciones, aunque no revistan gravedad con el objetivo de poder realizar un registro fidedigno de ellas.
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Mak C, Graham S, Deva A. Development of Acute Seroma Around Breast Implants Following Administration of COVID-19 Vaccination. Aesthet Surg J 2022; 42:NP440-NP442. [PMID: 35134133 PMCID: PMC9383379 DOI: 10.1093/asj/sjab412] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Cindy Mak
- Department of Breast Surgery, Chris O’Brien Lifehouse, Camperdown, NSW, Australia
| | - Susannah Graham
- Department of Breast Surgery, Chris O’Brien Lifehouse, Camperdown, NSW, Australia
| | - Anand Deva
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia
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Mahrhofer M, Weitgasser L, Schoeller T. Overview of Reported Breast Implant-related Reactions After COVID-19 Infection or Vaccination. Aesthet Surg J 2022; 42:NP569-NP570. [PMID: 35435942 PMCID: PMC9383747 DOI: 10.1093/asj/sjac101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maximilian Mahrhofer
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Stuttgart , Germany
| | - Laurenz Weitgasser
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Stuttgart , Germany
| | - Thomas Schoeller
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Stuttgart , Germany
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Guo X, Li T, Wang Y, Jin X. Sub-acute hypersensitive reaction to botulinum toxin type A following Covid-19 vaccination: Case report and literature review. Medicine (Baltimore) 2021; 100:e27787. [PMID: 34889230 PMCID: PMC8663829 DOI: 10.1097/md.0000000000027787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Botulinum toxin type A (BTA) is one of the most widely used injectable agents in cosmetic surgery. Corona virus disease 2019 (Covid-19) infection and vaccination, which can induce specific and nonspecific activation of the immune system, has been reported to induce delayed inflammatory reactions to previously injected hyaluronic acid fillers. However, there are no reports about the interaction between BTA and Covid-19. We aimed to report 2 sub-acute cases of allergic reactions to BTA in facial cosmesis following the Covid-19 vaccination. PATIENT CONCERN A 35-year-old and a 34-year-old female who has several previous BTA injections without any adverse effects experienced facial swelling, flu-like symptoms after BTA treatment following the Covid-19 vaccination. DIAGNOSE According to the typical clinical manifestation, a hypersensitive reaction to BTA was considered. INTERVENTION Corticosteroids and antihistamine were administered empirically. OUTCOMES The flu-like symptoms recovered over the next day, but the facial swelling gradually faded within 1 to 2 weeks. LESSONS A literature review was also conducted to summarize the hypersensitive actions to cosmesis related to Covid-19. We recommend BTA injection be administered at least 2 to 3 months after Covid-19 vaccination.
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Tozinameran. REACTIONS WEEKLY 2021. [PMCID: PMC8520093 DOI: 10.1007/s40278-021-03951-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mahrhofer M, Weitgasser L, Schoeller T. Observations of a Potential Immune Response to Breast Implants After Immunization With COVID-19 Vaccines. Aesthet Surg J Open Forum 2021; 3:ojab035. [PMID: 34704018 PMCID: PMC8538899 DOI: 10.1093/asjof/ojab035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Maximilian Mahrhofer
- Corresponding Author: Dr Maximilian Mahrhofer, Department for Plastic, Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Boeheimstraße 37, 70199 Stuttgart, Germany. E-mail:
| | - Laurenz Weitgasser
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Stuttgart, Germany
| | - Thomas Schoeller
- Department of Plastic, Reconstructive and Aesthetic Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University Tuebingen, Stuttgart, Germany
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