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Paul C Edwards1, John E Fantasia21Associate Professor (Clinical), Department of Periodontics and Oral Medicine, Pathology and Oncology, University of Michigan School of Dentistry, Ann Arbor MI, USA; 2Chief, Division of Oral Pathology, Department of Dental Medicine, Long Island Jewish Medical Center, New Hyde Park, NY, USAAbstract: Although only recently introduced, chemically-modified hyaluronic acid dermal fillers have gained widespread acceptance as “redefining” dermal fillers in the fields of dermatology and cosmetic facial surgery. Although hyaluronic acid-based dermal fillers have a low overall incidence of long term side effects, occasional adverse outcomes, ranging from chronic lymphoplasmacytic inflammatory reactions to classic foreign body-type granulomatous reactions have been documented. These long-term adverse events are reviewed.Keywords: hyaluronic acid, Restylane®, Hylaform®, injectable dermal filler, foreign body reaction, granuloma