Atrophy of the fatty tissue might occur, especially in the forehead region (Fig. 6.6). This can be corrected with a biodegradable filler (e.g., hyal-uronic acid if the source of the initial reaction is not hyaluronic acid but another filler). The continuous administration of highly potent steroids at short intervals should be accompanied by osteoporosis prophylaxis, especially in high-risk patients. One tablet of a combination of calcium carbonate 1.25 g and cholecalciferol (Vitamin D3) 10 ^g should be sufficient.
Plastic surgery might be helpful in those patients in whom granulomatous reactions are limited to defined areas. Patients should be aware that all surgical interventions will lead to some kind of scarring.
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