Persistent Trigeminal Neuralgia‐Like Pain Following Isolated Hyaluronic Acid Lip Augmentation: A Case Report

ABSTRACT Background Hyaluronic acid (HA) fillers are widely used for lip augmentation and are generally associated with a favorable safety profile. While vascular complications are well recognized, non‐vascular neurological adverse events, including trigeminal neuropathic pain, remain underreported, particularly following procedures in anatomically lower‐risk areas such as the lips. Objective To report a rare case of persistent trigeminal neuralgia‐like pain following HA lip augmentation and to highlight diagnostic and therapeutic considerations. Methods A 49‐year‐old woman developed persistent facial pain 10 days after HA lip augmentation. Clinical evaluation included dental assessment, imaging studies, and high‐resolution ultrasound of the perioral region. Initial management with hyaluronidase, corticosteroids, and non‐steroidal anti‐inflammatory drugs was performed. Due to persistent symptoms, a neuropathic pain‐oriented treatment with pregabalin and palmitoylethanolamide (PEA) was initiated. Pain severity was assessed using a visual analog scale (VAS), and follow‐up was conducted over 3 months. Results The patient presented with severe bilateral facial pain and paresthesia (VAS 7), refractory to conventional anti‐inflammatory treatment. Imaging excluded dental pathology and vascular complications, while ultrasound revealed localized post‐procedural tissue changes. Following initiation of pregabalin and PEA, a significant and sustained reduction in pain was observed (VAS 2 at 1 month; VAS 1 at 3 months). Conclusion Persistent trigeminal neuralgia‐like pain represents a rare but clinically relevant complication of HA lip augmentation. This case supports a neuropathic and neuroinflammatory mechanism and underscores the importance of early recognition and targeted treatment. Awareness of this complication may improve clinical outcomes and guide management strategies in aesthetic practice.