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Filler Materials: Indications, Contraindications, and Special Considerations in Oncology Patients
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
We must remember that many of our patients, before being diagnosed, have undergone aesthetic-medical treatments that in some way may also be affected by different cancer treatments or may interfere with the results of some diagnostic tests. For example, patients with long-term implants such as polyalkylimides (Bio-Alcamid) or polyacrylamides (Aquamid) can present cases of infection and even biofilm formation due to alterations in the immune system, despite having the implant for years in the tissue [10–12].
Improvement of palmoplantar pustulosis after excision of polyacrylamide injected into the nasal region
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Kazuya Kashiyama, Jinyoung Lee, Kazufumi Koga, Yumi Matsuo, Katsumi Tanaka
PAAG is a non-absorbable water-soluble gel. It is used in augmentation mammoplasty, rhinoplasty, and treatment of wrinkles, and is promoted as a relatively easy procedure that can be performed under local anesthesia. It does not require hospitalization, has a short downtime after surgery, does not require repeated injections because the substance is non-absorbable, unlike hyaluronic acid, and provides a natural appearance. It is composed of polyacrylamide (2–4%) and saline (96–98%), and is polymerized as a chain polymer to remove the biological membrane permeability of acrylamide to detoxify it. However, its safety is currently under discussion [8]. PAAG was introduced as a new material for augmentation mammaplasty around 2000 in China, but its manufacture, sale, and injection are now prohibited because of adverse effects. No major complications were observed over several years of observation in the early phase after its use for augmentation mammaplasty, but problems have been observed over long-term observation such as aberration of other regions, induration, infection, mastitis, and impairment of breastfeeding [9]. PAAG was reported to be safe because it is highly biocompatible and not carcinogenic, unlike another simple substance, Aquamid [10,11]. However, concerns about neurotoxicity and carcinogenicity have been frequently reported [9,12–14].
Delayed adverse reactions caused by consecutive injections of different fillers in the same region: Murine skin study
Published in Journal of Cosmetic and Laser Therapy, 2019
Euyhyun Chung, Changyoon Sim, Hyun Jo Kim
Permanent fillers have a higher potential to develop granulomatous reactions than resorbable fillers. Some permanent fillers are silicone, microspheres of polymethylmethacrylate suspended in bovine collagen (Artecoll®, Artefill®), polyacrylamide hydrogel (Aquamid®, Interfall®, OutLine®, Royamid®, Formacryl®, Argiform®, Amazingel®, Bio-Formacryl®, and Kosmogel®), Hydroxyethylmethacrylate/ethylmethacrylate fragments and hyaluronic acid (Dermalive®, Dermadeep®), and Polyalkylimide gel (Bio-Alcamid®) (Table 2). As silicone which is well known for granulomatous response with a ‘Swiss cheese appearance’, Artecoll® also displays distinctive histologic features. Artecoll® consists of homogenous microspheres of PMMA uniformly suspended in a solution collagen (3.5%) with 0.3% hydrochloride lidocaine (17). The collagen is selected from healthy animals which contribute to a reduction in adverse reaction. All of the spheres are smooth-surfaced, measuring about 32–40 μm. As shown in this study, it is characterized by multiple small round cystic spaces of approximately the same size and shape which mimics normal adipocytes surrounded by epithelioid cells with foreign body-type multinucleated giant cells in a sclerotic stroma showing class II foreign body reactions.