ABSTRACT Background Acupoint embedding (AEM) therapy merges traditional acupuncture with modern biomaterials to treat various diseases and for cosmetic uses, especially obesity and facial anti‐aging. Research Objective To examine complications from acupuncture embedding therapy (AEM), focusing on foreign body granulomas and infections. The study reviews cases to understand their causes, symptoms, diagnosis, treatment, and prevention, aiming to offer new treatment options for granulomas from acupuncture. Methods Using PRISMA guidelines, a literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library with keywords related to thread embedding acupuncture and its adverse effects, covering 2014–2024. Nine articles were included, along with a 2023 case report of a woman developing a granuloma after collagen thread acupuncture for weight loss. Results Among the 11 cases of complications following acupuncture point thread implantation, foreign body granuloma accounted for 90.91%, making it the most prevalent type of complication associated with this therapy. This case report details a treatment involving antibiotics to reduce exudate, steroids to shrink the mass, and later, a combination of warm acupuncture and radiation therapy to further reduce the nodule. However, surgical treatment yields the most significant therapeutic effect for foreign body granulomas. Conclusion Animal‐derived sutures, like catgut, often cause foreign body granulomas quickly. If these granulomas resist treatments like steroids or antibiotics, surgery is the best option. Clinicians must recognize the high risk of granulomas and prioritize using biocompatible sutures, maintaining aseptic techniques, ensuring precise suture placement, and closely monitoring patients post‐surgery. For small early‐stage nodules, consider medication and warm acupuncture. For stubborn or larger lesions, prompt surgery is vital to reduce complications and improve outcomes.
Xu et al. (2026) studied this question.