Complications of Long-Lasting Facial Fillers

Abstract

Introduction: Although facial fillers have been popular for years, some complications have been associated with their injection or inappropriate application. Because these products are so long lasting, such untoward consequences would be difficult or impossible to correct without surgical intervention. Despite the attractions that longevity and permanency offer, the long-term effects of injecting long-lasting fillers such as acryl pearls and polyacrylamide facial filler materials deserve serious consideration by both physicians and patients before injection treatment is initiated. The author presents in this article the results of his research into possible adverse reactions to facial fillers. Methods and Materials: A total of 110 patients were selected for this study, and each received an injection into a single location on the face. Ten patients were treated with Artecoll and 100 patients were treated with Dermalive (n = 50) and Dermadeep (n = 50). The injections were made in the glabella, nasolabial fold, lips, perioral, cheeks, and chin. To achieve a more accurate study result, injection into a single area of the face at a time was necessary. Results: Between 1992 and 2003, 57 patients presented with problems after acryl injections into the face. The granulomas caused by Artecoll were smaller and fewer than those caused by Dermalive and Dermadeep. Discussion: Two products that are relatively new to the esthetic treatment industry are poly-L-lactic acid, also known by the product names Sculptra in the United States and New-Fill in Europe, and hydrophilic polyacrylamide gel, known by the product names Bio-Alcamid, Amazingel, and Aqua-Mid. These materials also form granulomas. The ethical question about whether we as surgeons should implant materials into the face that we can never completely remove without damaging the surrounding healthy tissue should be discussed further. Conclusions: Permanent fillers that provide satisfactory results at first may become more visible or create an unnatural appearance as aging progresses. Because these products are so long lasting, such untoward consequences would be difficult or impossible to correct without surgical intervention. Given these problems, it is legitimate to question the necessity for such permanent fillers.