Cosmetic Eyelid Surgery in Beverly Hills – Dr. Guy Massry
8Jun/110

5-Fluorouracil for the treatment of scars and granulomas from fat grafting

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5-Fluorouracil is an anti-metabolite long used for treatment of cancer and more recently in an intralesional (into scar) fashion as an effective modality in the management of dermal scars, particularly hypertrophic scars and keloids. In ophthalmology, it is been used to prevent scarring after trabeculectomy (glaucoma) surgery.  I use 5-Fluorouracil to manage cutaneous (skin) scars in patients after surgery, and have been very pleased with the results and negligible side effect profile. I still add some steroid in the injection (75% 5-FU 50 mg/ml/25% Kanalog 5mg/ml) to reduce pain and potential inflammation after injection. With this mixture I have not seen the tissue atrophy which can occur with steroid injections and feel 5-Fluorouracil is more efficacious in minimizing scar formation.

I also use 5-Fluorouracil during revisional (redo) surgery to prevent postoperative scarring and to help modulate healing of the wound.  The last modality I use 5-Fluorouracil for is in patients who had fat grafting and ended up with contour irregularities (lumps/bumps).  I find that patients can develop hard nodules (granuolmas) to injected fat used to fill depressions and hollows.  These granulomas are inflammatory reactions as the body considers the fat foreign to the area and tries to attack it immunologically.   These granulomas are difficult to treat and until the advent of 5-Fluorouracil I had poor success managing these irregularities.  5-Fluorouracil has changed this and I have found that most patients have at least a partial response with the medication

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