CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(02): 253-256
DOI: 10.1055/s-0042-1760364
Case Report

A Rare Case of Migration of Hyaluronic Acid Gluteal Injection to the Medial Thigh Presenting as a Soft Lump

Ahmed Saad
1   Department of Orthopedics, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
1   Department of Orthopedics, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom
2   Deprtment of Orthopedics, Southport and Ormskirk Hospital NHS Trust, Southport, United Kingdom
A. Mark Davies
3   Department of Musculoskeletal Radiology, University Hospitals of Leicester, Leicester, United Kingdom
Rajesh Botchu
3   Department of Musculoskeletal Radiology, University Hospitals of Leicester, Leicester, United Kingdom
› Institutsangaben
Funding None.


Introduction Hyaluronic acid (HA) is a widely accepted agent most commonly used as a dermal filler in facial aesthetic/cosmetic medicine. More recently, HA has been utilized for gluteal augmentation. The common side effects of HA injection are often minor and self-limiting. HA migration is a very rare complication.

Case Report We describe a rare case of HA buttock injection migration in a transgender patient, appearing as a superficial lump on right thigh representing a diagnostic dilemma. We highlight the need of a clinical suspicion and discuss the appropriate investigations for guided management of such patients.

Conclusion It is essential for reporting radiologist to be aware of the commonly used injectable fillers, their complications, and imaging findings to avoid misdiagnosis and guide optimal patient management.


Consent was obtained from patient for this study.


Artikel online veröffentlicht:
13. Januar 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Salsberg J, Andriessen A, Abdulla S. et al. A review of protection against exposome factors impacting facial skin barrier function with 89% mineralizing thermal water. J Cosmet Dermatol 2019; 18 (03) 815-820
  • 2 Alharbi M. Review of sterility of reused stored dermal filler. J Cosmet Dermatol 2019; DOI: 10.1111/jocd.12932.
  • 3 Walker K, Basehore BM, Goyal A. et al. Hyaluronic Acid. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. . Accessed December 17, 2022 at:
  • 4 De Meyere B, Mir-Mir S, Peñas J, Camenisch CC, Hedén P. Stabilized hyaluronic acid gel for volume restoration and contouring of the buttocks: 24-month efficacy and safety. Aesthetic Plast Surg 2014; 38 (02) 404-412
  • 5 Becker M, Balagué N, Montet X, Calmy A, Salomon D, Toutous-Trellu L. LIPO and Metabolism Group. Hyaluronic acid filler in HIV-associated facial lipoatrophy: evaluation of tissue distribution and morphology with MRI. Dermatology 2015; 230 (04) 367-374
  • 6 Lin DJ, Wong TT, Ciavarra GA, Kazam JK. Adventures and misadventures in plastic surgery and soft-tissue implants. Radiographics 2017; 37 (07) 2145-2163
  • 7 Gold MH. Use of hyaluronic acid fillers for the treatment of the aging face. Clin Interv Aging 2007; 2 (03) 369-376
  • 8 International Society of Aesthetic Plastic Surgeons. IAPAS international survey on aesthetic/cosmetic procedures in 2017; 2018. Accessed December 17, 2022 at:
  • 9 Chae SY, Lee KC, Jang YH, Lee SJ, Kim DW, Lee WJ. A case of the migration of hyaluronic acid filler from nose to forehead occurring as two sequential soft lumps. Ann Dermatol 2016; 28 (05) 645-647
  • 10 Mosleh R, Mukari A, Krausz J, Hartstein ME, Azzam SH. Orbit mass secondary to migration of dermal hyaluronic acid filler. JAAD Case Rep 2019; 5 (06) 488-490
  • 11 Almukhtar R, Fitzgerald R, Cotofana S, Fabi S. Migration of hyaluronic acid-based soft tissue filler from the temples to the cheeks-an anatomic explanation. Dermatol Surg 2021; 47 (11) 1526-1527
  • 12 Jordan DR, Stoica B. Filler migration: a number of mechanisms to consider. Ophthal Plast Reconstr Surg 2015; 31 (04) 257-262
  • 13 Chang JR, Baharestani S, Salek SS, Piluek WJ, Eberhart CG, McCulley TJ. Delayed superficial migration of retained hyaluronic acid years following periocular injection. Ophthal Plast Reconstr Surg 2017; 33 (3S, Suppl 1): S116-S118
  • 14 Urdiales-Gálvez F, De Cabo-Francés FM, Bové I.. Ultrasound patterns of different dermal filler materials used in aesthetics. J Cosmet Dermatol 2021; 20 (05) 1541-1548
  • 15 Mundada P, Kohler R, Boudabbous S, Toutous Trellu L, Platon A, Becker M. Injectable facial fillers: imaging features, complications, and diagnostic pitfalls at MRI and PET CT. Insights Imaging 2017; 8 (06) 557-572
  • 16 Beer KR. Radiesse nodule of the lips from a distant injection site: report of a case and consideration of etiology and management. J Drugs Dermatol 2007; 6 (08) 846-847