Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy

Rauso, Raffaele; Califano, Luigi; Rugge, Luigi; Chirico, Fabrizio; Tartaro, Gianpaolo

doi:10.1093/asj/sjy226

Cited by 11 publications

(17 citation statements)

References 6 publications

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“…Soft tissue augmentation with fillers has become increasingly popular for restoration of facial folds,wrinkles,volume and contour.Several non-biodegradable fillers,as silicone oil, polyacrylamide hydrogel, polymethylmethacrylate(PMMA), have been introduced in order to get long lasting results 1 .The main reason for patients asking permanent fillers instead of resorbable ones,as hyaluronic acid(HA), is related to the willingness to avoid repeated injections, although it has been clearly shown in literature that the only fillers than can be reversed by the use of an antidote are the HA-based ones 1,2 .Even though some studies have indicated permanent fillers as well tolerated with desirable aesthetic results and few complications,conversely many case reports have shown numerous adverse events 3 .Erythema,edema,bruising,infection,hypersensitivity,discoloration, vascular occlusion can be detected with all type of fillers as HA, calcium hydroxyapatite(CaHA), PMMA, poly-L-lactic acid(PLLA), however a feature not often considered and underestimated related to permanent substances, is the unpleasant appearance that may be achieved after some years after implantation 4,5 .Aging process modify facial anatomy,skeleton resorption and fat pads atrophy induces progressive tissue ptosis. For the same reason,also a permanent filler injected with transitory good result, years after implantation may induce a worsening of facial appearance during the aging process,creating a drooping/bulging effect 5,6 . In addition to the aging process of facial structures, permanent fillers may also develop delayed complications such as migration,granuloma, lumps and/or abscesses 3,5 .For these reasons, many patients are not satisfied with the long-term results following non-resorbable filler injections and years after implantation request removal of the products 3,5,[7][8][9][10][11] .The use of permanent fillers is totally or partially forbidden in some European countries such as Netherland and Poland, especially for the challenge to face their surgical removal 12 .Several non-surgical managements have been introduced to treat permanent filler…”

Section: Introductionmentioning

confidence: 99%

“…For the same reason,also a permanent filler injected with transitory good result, years after implantation may induce a worsening of facial appearance during the aging process,creating a drooping/bulging effect 5,6 . In addition to the aging process of facial structures, permanent fillers may also develop delayed complications such as migration,granuloma, lumps and/or abscesses 3,5 .For these reasons, many patients are not satisfied with the long-term results following non-resorbable filler injections and years after implantation request removal of the products 3,5,[7][8][9][10][11] .The use of permanent fillers is totally or partially forbidden in some European countries such as Netherland and Poland, especially for the challenge to face their surgical removal 12 .Several non-surgical managements have been introduced to treat permanent filler…”

Section: Introductionmentioning

confidence: 99%

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Aesthetic Surgical Pathway in Permanent Facial Filler Removal

Pascali

Chirico

Rugge³

et al. 2023

Facial Plast Surg

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Although permanent fillers have been introduced in order to get long lasting results, many studies have shown numerous severe and disfiguring complications. Non-surgical procedures may mitigate those adverse events but the only way to remove the filler previously injected is represented by surgical excision. We present a pathway of facial surgical accesses to be performed achieving two goals: permanent filler removal and restore facial aesthetic balance. The proposed surgical accesses are already standardized in aesthetic surgical practice in order to avoid direct excision and unpleasant facial scar. 231 patients underwent surgery for permanent filler removal and aesthetic restoration of the involved facial area, represented by forehead, glabella, nose, cheeks, eyelids, chin, jawline and lips. Magnetic resonance evaluation was performed with the exception of lip patients evaluated with ultrasound. Postoperative follow-up was 12months to 6years. Subjective and objective methods were used to outcome evaluation according to FACE-Q questionnaire. Functional and aesthetic correction was scored using the patient-graded Global Aesthetic Improvement Scale(GAIS), overall patient satisfaction was assessed by a five-point scale questionnaire. Functional and aesthetic restoration was globally recognized as improved according to the Global Aesthetic Improvement Scale. Patients reported high levels of satisfaction assessed by a five-point scale questionnaire. A very good satisfaction level was registered in both subjective and objective judgment scores. To the best of our knowledge, we present the largest case series regarding surgical removal of permeant facial fillers. A proper pre-operative evaluation, filler removal followed by restorative facial aesthetic surgery technique is paramount to approach challenging cases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Aesthetic Surgical Pathway in Permanent Facial Filler Removal

Pascali

Chirico

Rugge³

et al. 2023

Facial Plast Surg

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“…Although the patients' satisfaction is beyond the topic of this article, all the patients were happy or very happy with the results. However, when late-onset complications arose, in the two patients who required abscess drainage, their compliance dramatically decreased [39].…”

Section: Discussionmentioning

confidence: 99%

Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience

Chirico

Rauso²,

Fragola

et al. 2021

Applied Sciences

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Since the advent of HIV antiretroviral therapies at the end of the 20th century, the morbidity and mortality rates associated with HIV infection have decreased dramatically. Unfortunately, these benefits are associated with substantial morphologic changes in the body, such as abnormal fat distribution with peripheral lipohypertrophy and facial lipoatrophy. Facial wasting is considered the major stigma for HIV–infected people and may result in reduced antiretroviral adherence. Patients suffering from the stigmata of HIV infection can benefit from non-surgical aesthetic treatments performed with fillers or lipolytic agents that provide a quick and reliable service for facial rejuvenation, with high patient satisfaction and a low risk of complications. In the present paper, a retrospective analysis of complications following non-surgical aesthetic treatments (calcium hydroxyapatite-based filler, hyaluronic acid filler, polyacrylamide hydrogel filler and dehoxycholic acid injections), in a cohort of 116 consecutive HIV+ patients, treated over a period of 12 years, was performed. With the exception of the tardive swelling reported after calcium hydroxyapatite injections, complications were recorded just after polyacrylamide hydrogel treatment as small, palpable, nonvisible nodules or aseptic abscess. Our experience is consistent with those already published in the literature and the complication rate seems to be comparable to non-infected patients.

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“…Although HA injections are excellent tools utilized in facial cosmetic improvements, they could also be applied to treat facial deformities resulting from traumatic events, orbital and periorbital surgeries, tumor resections, congenital deformities, burns, scars, and facial palsy [8][9][10][11]. Injective techniques could also be utilized for HIV-related facial lipoatrophy or progressive hemifacial atrophy [12][13][14][15][16][17]. Although hyaluronic acid is widely used for cosmetic purposes, in the literature, little is known about this procedure in reconstructive approaches [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Injective techniques could also be utilized for HIV-related facial lipoatrophy or progressive hemifacial atrophy [12][13][14][15][16][17]. Although hyaluronic acid is widely used for cosmetic purposes, in the literature, little is known about this procedure in reconstructive approaches [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery

Chirico¹,

Colella

Cortese

et al. 2021

Applied Sciences

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The use of hyaluronic acid (HA) injectable fillers has become increasingly widespread in facial recontouring and rejuvenation. We report our experiences to emphasize the role of HA fillers as tools beyond aesthetic treatments in cases of post-surgical facial sequelae. HA fillers are generally used for aesthetic rejuvenation, but one potential new horizon could be their application in trauma, reconstructive, and craniofacial surgery. This study was conducted retrospectively, evaluating medical reports of patients treated at the Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, for lip incompetence, trauma, oncological, reconstructive, and craniosynostosis surgery sequelae. Visual analog scale (VAS) evaluation was performed to assess patient satisfaction. No major complications (i.e., impending necrosis or visual loss) were reported. Bruising and swelling was reported for 48 h after lip injection. At the immediate VAS evaluation, 67% of the patients were “extremely satisfied” and 33% “satisfied”. In those 33%, VAS scores changed to “extremely satisfied” at 6–9 weeks and 3–6 months of VAS evaluation (contextually to improvement in tissue flexibility, elasticity, and aesthetic appearance). Results indicate that this minimally invasive approach achieves a high level of aesthetic enhancement, improving patient satisfaction. The concept of HA filler applications could be a frontier that may be applicable to other areas of reconstructive facial plastic surgery.

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Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy

Cited by 11 publications

References 6 publications

Aesthetic Surgical Pathway in Permanent Facial Filler Removal

Aesthetic Surgical Pathway in Permanent Facial Filler Removal

Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience

Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery

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