Surgery for Foreign Body Reactions due to Injectable Fillers

Abstract

Background: An increasing number of soft tissue fillers have been introduced to the beauty market and these filler substances are widely used as non-toxic, non-immunogenic and relatively harmless injectable alternatives to surgical rejuvenation. Generally, facial fillers are injectable – or surgically insertable – products that are used to fill up the volume loss in the aging face. Depending on bioavailability, chemical composition and degradation, fillers can be classified as temporary or permanent, organic or inorganic and autologous or heterologous. Objective: A plethora of new products has swamped the beauty market since face rejuvenation has become socially acceptable as well as affordable to a wider population, but adverse reactions cannot be excluded. We present 4 patients with complications after injection of facial fillers [including Artecoll®(polymethylmethacrylate microspheres), Restylane® (hyaluronic acid), DermaLive® (hyaluronic acid plus acrylic hydrogel particles) and Newfill® (polylactic acid)] and surgical correction. Results: Surgical intervention led to good aesthetic and functional results after multiple unsuccessful conservative therapies. Conclusion: We recommend that only physicians familiar with the injection techniques and the biological and chemical characteristics of the various injectable products should perform such interventions. Especially permanent fillers should be used with utmost reticence in cosmetic surgery and we would recommend their application only in reconstructive procedures. Additionally, documentation and reporting of all adverse effects must be mandatory.

Lip Nodules Caused by Hyaluronic Acid Filler Injection: Report of Three Cases

“…However, a few cases of hypersensitivity and foreign body reaction have been documented, usually developing within 6-24 months [5][6][7][8][9][10][11][12][13][14][15]35].…”

Safe and Curative Brachytherapy Reirradiation with Organ-Sparing Hyaluronate Gel Injection

“…In response, Vordermark et al proposed that a material with a faster resolution would be suitable for application to HDRIBT [Vordermark, 2008]. These long-lasting hyaluronate implants may cause immune [Hamilton, 2007] or inflammatory reactions [Arron, 2007], or infections [Christensen, 2009] [Arron, 2007;Edwards, 2007;Ghislanzoni, 2006;Wiest, 2009;Wolfram, 2006], and have been surgically removed from some patients [Arron, 2007;Edwards, 2007;Ghislanzoni, 2006;Wiest, 2009;Wolfram, 2006]. 2.…”

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

“…68 Allen and collaborators, in a longitudinal study, checked the cellular reactions after the injection of inert implants. These reactions were followed by a series of events of variable magnitude.…”

“…73 However, this product has also been used on the treatment of nasogeniano sulcus, correction of bone eminences atrophy, mainly malar and mentonian, on the Romberg´s hemifacial atrophy, correction of nasal dorsum, correction of scars and of atrophic earlobe. 68 PMMA is used in many countries and the number of treated patients worldwide surpassed 250.000 patients in 2005. Amongst those, only 0,01% developed granuloma formation.…”