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Polyacrylamide
Hydrogel as A Long-Lasting and Permanent Soft Tissue Filler, 4 Years
Experience
Atef A. Allam(1), Abdel Mohsen K. Abou El Dahab(2)
& Nahla R. Ghaly(3)
Plastic and Reconstructive Surgery Unit, Tanta Faculty of
Medicine(1), Department of Plastic and Reconstructive Surgery,
Alexandria Faculty of Medicine(2) & Department of
Dermatology and Venereology, Tanta Faculty of Medicine(3),
Egypt
Tanta Med. Sc. J 2008; 3(4):77-87
Article type: Original article
Background/Aim: Soft tissues augmentation has been tried for decades
and many materials were used including biological and artificial
fillers. Many synthetic injectable augmentation fillers were used
but unfortunately, none of them was ideal. Polyacrylamide gel (PAAG)
is a group of non-absorbable, long-lasting, non allergic, malleable
and relatively cheap soft tissue fillers that have been extensively
used in the Europe, Middle East and many countries for more than 10
years with satisfactory augmentation results and few complications
on the short-term follow-up duration. In this study, we report more
than 4-years experience in using two types of injectable PAAG for
facial and body soft tissue augmentation. We used Bio-alcamid for
facial augmentation and Esteform for lower limb augmentation.
Patients & Methods: A total of 618 patients were injected with PAAG.
Bio-alcamid was used to augment different areas in the face in 571
patients. It was injected into the malar, nasolabial lines, buccal,
lateral face, chin and temples, while Esteform was injected in the
gluteal areas, thighs and legs in 47 patients. The follow-up period
ranged between 15 and 48 months. Results: The early post-procedure
(after 2 weeks) augmentation results showed that 96.1% (594
patients) expressed satisfaction but the later aesthetic results and
satisfaction were decreased over the follow-up time. Among our
series, 73 patients (11.8%) required more than one session of
injection either for more augmentation (52 patients = 8.4%) or touch
up to correct asymmetry or irregularities (21 patients =3.4%). The
overall incidence of the reported complications was 6.6%, where 41
patients had developed delayed adverse reactions at or near the
injection sites. 7 out of these 41 patients developed multiple
complications along the follow-up period. Nodularity, infection,
migration, induration and disfigurement represented the most common
reported complications and were treated with either surgical or
conservative treatment. Conclusion: PAAG is long lasting filler that
gives high rate of early satisfaction but with several delayed
adverse effects. It is not safe, especially in the face, and needs
high skills to minimize its related complications. These
complications usually occur months or even years after injection and
are difficult to treat, which is why the best way to minimize
complications is to avoid these types of fillers.
ICID 881852 |