Complications of Inject able Synthetic Polymers in Facial Augmentation

Abstract

Injectable synthetic polymers can produce significant complications including deformity and inflammatory tissue destruction, the control of which is complicated by the difficulty of removing the materials. Removable tissue fillers, such as e-PTFE, or natural materials such as collagen, autologous, fat, or Alloderm, should be considered instead.

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

“…However, what was more impressive was the rather late onset of foreign body granuloma at 10 to 15 years after injection. 5,56,60,61 Therefore, the U.S. Food and Drug Administration limited liquid injectable silicone use in 1965 to a certain number of patients of selected investigators. 51,57 The outcome of this clinical trial on patients with hemifacial atrophy, however, was disappointing.…”

Foreign Body Granulomas Caused by Polymethylmethacrylate Microspheres

“…Attraction of numerous macrophages and phagocytosis has so far been mainly described for particles with a rough or porous surface and a small size of up to 15 µm. [7][8][9] Chronic inflammation frequently resulting in undesireable capsule fibrosis may follow the phagocytosis of synthetic implants with irregular surface characteristics. On the other hand, it is assumed that PMMA microspheres cannot be phagocytized or removed, and the material is believed to be permanently deposited because of its larger size and completely smooth surface.…”

“…5 In general, all synthetic polymer implants lead to some inflammatory response either by surgical trauma or by interactions of the tissue with the implant. 6,7 When the polymer is exposed to the biological environment, its surface is first coated with a layer of proteins, 6 preferably adsorbed proteins. The extent of possibly uncoated surface structures of the polymer depend on its physicochemical properties and its surface characteristics.…”

Erratum: Corrigendum

“…Factors influencing their development include properties of the filler, the volume injected and previous infection or trauma, hypersensitivity reaction to the hyaluronic acid carrier or an underlying or associated infection. 3 Tyssen and Menne suggest that an allergic contact dermatitis response to the methylmethacrylate monomers may be an important aetiological factor. 4 The shape of the microspheres may induce a more severe granulomatous reaction.…”