Introduction:

Hyaluronic acid (HA) is a safe and commonly used filler for soft tissue augmentation. However, some complications can occur, particularly if the technique of application is inadequate or the quality of the material is poor.

Objective:

To underline the importance of clinical examination in the era of rapid technological development.

Case report:

A 27-year-old woman presented to our clinic due to poor aesthetic results after multiple lip augmentation using hyaluronic acid injections followed by an unsuccessful treatment in a different medical centre in which she was overdiagnosed. The patient underwent several hyaluronidase injections and an ultrasound-guided core biopsy. Hyaluronic acid was not found in any of the taken specimens. Next, surgical removal of the filler was proposed. We proposed hyaluronidase and antibiotic treatment that resulted in a satisfactory aesthetic effect.

Conclusions:

Additional tests can be useful in managing complications of hyaluronic acid procedures, but they should be correlated with clinical expertise.