title: NewFill for skin augmentation: a new filler or failure?
abstract: BACKGROUND
  New injectable materials for skin augmentation that promise to be the ideal filling material are introduced every year. Recently, we treated three patients with adverse reactions to a new substance for skin augmentation: polylactic acid (NewFill, Ashford Aesthetics Inc, Belgium).
  
  
  OBJECTIVE
  To present three cases in which serious adverse reactions had occurred after skin augmentation with a new filling substance, polylactic acid (NewFill). Because an identical substance (Sculptra, Aventis Pharmaceuticals, Bridgewater, NJ, USA) was recently introduced in the United States, we want to alert future users of these substances to possible adverse events.
  
  
  METHODS
  We report three cases with serious adverse events more than 12 months after skin augmentation with polylactic acid (NewFill). They were treated with intralesional steroid therapy and topical imiquimod application.
  
  
  RESULTS
  Both intralesional steroid therapy and topical imiquimod application lead to moderate results. If feasible, surgical excision is the best available option.
  
  
  CONCLUSIONS
  Great care should be taken when polylactic acid is used for intradermal injection because giant cell granulomatous reactions may be the result. Other than surgical excision, effective treatment options are lacking.
authors: Department of Dermatology, Kennemer Gasthuis, Haarlem, The Netherlands.
authors: Rob C
authors: RC
authors: Beljaards
authors: Kees-Peter
authors: KP
authors: de Roos
authors: Frank G
authors: FG
authors: Bruins
mesh_terms: D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007271:Injections, Intradermal; D019344:Lactic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage / Q000009:adverse effects*; D019736:Prostheses and Implants / Q000009:adverse effects*; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)