title: Complications of polyalkylimide 4% injections (Bio-Alcamid): a report of 18 cases.
abstract: Injectable filler materials can be valuable to aesthetic surgeons. To date, hardly any short-term and no long-term complications of polyalkylimide injections (Bio-Alcamid) have been reported. We present and discuss the history of 18 patients who had such complications. The patients were between 31 and 55 years of age. The time between injection and the onset of complications of polyalkylimide ranged from 1 month to 3 years. Additional invasive therapy at, or near, the site of injections triggered the onset of infection in 10 patients. By use of T2-weighted MRI with fat suppressing spectro-presaturation inversion recovery (SPIR) the filler material can be visualised. Once infection or migration of the permanent filler occurs, the therapeutic options are limited to surgical removal by a direct approach. Polyalkylimide should be handled under strict antiseptic circumstances. This does not only apply at the time of initial injections, but even more during any subsequent invasive treatment such as evacuation of surplus deposits or additional surgical procedures at, or near, the site of injection.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Onze Lieve Vrouwe Hospital, P.O. Box 95500, 1090 HM Amsterdam, The Netherlands. r.b.karim@olvg.nl
authors.forename: R B
authors.initials: RB
authors.lastname: Karim
authors.forename: J J
authors.initials: JJ
authors.lastname: Hage
authors.forename: L
authors.initials: L
authors.lastname: van Rozelaar
authors.forename: C A H
authors.initials: CA
authors.lastname: Lange
authors.forename: J
authors.initials: J
authors.lastname: Raaijmakers
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects*; D000328:Adult; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology / Q000473:pathology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy*; D006801:Humans; D007239:Infections / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015361:Rhytidoplasty / Q000009:adverse effects
chemical_list: D000180:Acrylic Resins; C470344:Bio-Alcamid