By Cheryl Guttman Krader

Patients interested in soft-tissue augmentation with an injectable filler may consider permanency a desirable attribute. However, severe and serious adverse reactions following filler injections are most likely to occur with these nonresorbable materials, and the risk for a disastrous complication is too high to justify their use in cosmetic indications, says Firas Hamdan, MD.

Speaking at the 2011 annual scientific meeting of the American Academy of Cosmetic Surgery (AACS), Hamdan noted that complications of permanent injectable fillers may be of cosmetic or medical significance and range from minor asymmetries to major disasters. In all cases, however, the solution will likely involve surgical intervention, which most patients were seeking to avoid in the first place by choosing treatment with an injectable filler. In some situations, the complication may lead to devastating consequences.

"Although patients may view permanent fillers as a more economical alternative to materials that require periodic touch-up injections, the difference in cost will be quickly offset if a complication occurs necessitating surgical intervention," says Hamdan, who is board-certified in otolaryngology and practices cosmetic surgery at the Cosmetic Surgery Clinic, Beirut, Lebanon, and at the American Academy of Cosmetic Surgery Hospital in Dubai, United Arab Emirates. "Although the risk of a serious complication with a permanent injectable filler is low, any such risk is too high for an elective cosmetic procedure."

Permanent filler injected in face for volumizing that resulted in necrotic tissue and abscess formation, necessitating surgical drainage and repair under general anesthesia.

Hamdan says complications of permanent injectable fillers can be considered from the perspective of the patient or the surgeon. Patients may be displeased with the cosmetic outcome either early after the procedure if the achieved appearance does not match their expectations, or later on as their desired goal changes with time. In addition, with any permanent filler there is a risk for complications to develop as a result of the host response to the nonresorbable foreign material.


[Source: Modern Medicine/Cosmetic Surgery Times]