Usefulness of the Versajet Hydrosurgery System for the Removal of Foreign Body Granuloma

Materials used for cosmetic/reconstructive purposes can elicit foreign body reactions, resulting in granulomas. Foreign body granulomas are treated with intralesional corticosteroid injections and excisional surgery [ 1 ]. A 44-year-old woman presented with irregularities and areas of hardness across the forehead, glabella, and temple. She had undergone a cosmetic procedure involving the injection of an unknown material into these sites 10 years before. We diagnosed the case as foreign body granuloma. We administered 2 intralesional triamcinolone injections (20 mg/mL) at 1-month intervals, but the discomfort persisted. Therefore, we performed surgery using the Versajet hydrosurgery system. The patient was administered anesthesia via propofol, followed by local anesthesia with lidocaine. After 1-cm incisions in both suprabrow areas and 2-cm incisions in the temple area were made, dissection was performed subcutaneously ([ Fig. 1 ]). We approached the target areas with the 15° Versajet handpiece to remove approximately 5 mL of granuloma fluid ([ Fig. 2 ]). A postoperative compression dressing was maintained for 3 days to prevent hematoma. The swelling persisted for 1 month. After 3 months of follow-up, the irregularities had improved, and the patient was satisfied with the cosmetic outcomes ([ Fig. 3 ]). Fig. 1. Incision site on both the temporal area and the suprabrow area (red line). Fig. 2. Versajet hydrosurgery system and the 15° handpiece device. Fig. 3. (A) Preoperative full-face anteroposterior view. (B) Postoperative view. Versajet uses a razor-thin saline jet for tissue debridement and involves reduced scarring because of the smaller incisions. Sterile saline is used for tissue irrigation while the granulomas are removed; the remaining debris is washed out through a localized vacuum effect. The procedure can be completed quickly because the number of debridement sessions required decreases during the procedure [ 2 ] [ 3 ]. Versajet may be a useful tool for the surgical removal of foreign body granulomas. Publication History Received: 04 April 2017 Accepted: 07 July 2017 Article published online: 20 April 2022 © 2017. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/) Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA