Complications of injectable synthetic polymers in facial augmentation

BACKGROUND. Injectable synthetic materials have been used for augmentation of soft tissue defects, correction of wrinkles, and augmentation of facial features such as the nasal dorsum. Success has been limited by inflammatory reactions, material migration, and the difficulty of removal should complications occur. OBJECTIVE. TO evaluate complications resulting from soft tissue augmentation with injectable alloplastic materials. METHODS. Retrospective review of seven cases. Clinical history, treatment, histopathologic findings, and outcomes are assessed. RESULTS. Inflammatory reaction and tissue damage were refractory to antibiotics and steroids, and surgery was required to remove the foreign material. Histologic examination revealed giant cell foreign body reaction in all cases. CONCLUSION. 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. (C) 1997 by the American Society for Dermatologic Surgery, Inc.