title: Complications after treatment with polyalkylimide.
abstract: BACKGROUND
  Polyalkylimide is a nonresorbable, biocompatible polymeric filler that has been used for several years to treat soft tissue deficits. The literature has shown a minor complication rate. We noticed that complications typically appear several years after injection.
  
  
  OBJECTIVE
  To evaluate the complications reported after treatment with polyalkylimide.
  
  
  METHODS
  We describe a retrospective evaluation, reported by members and candidate members of the Dutch Society of Cosmetic Medicine, of complications after use of polyalkylimide.
  
  
  RESULTS
  In total, 3,196 patients were treated, and 4,738 treatments were performed, from which 154 complications (patient complication rate 4.8%, treatment complication rate 3.3%) were reported. The most common complication was inflammation; other complications were hardening, migration, and accumulation of the product. In some patients, skin biopsy followed by histologic examination was performed.
  
  
  CONCLUSIONS
  Treatments with polyalkylimide have been reported to give rise to complications years after treatment. Even though the study described is a retrospective evaluation, we consider an overall complication rate of 4.8%, the severity of the complications, and the difficulty in treating them too high a risk for a cosmetic treatment. The Dutch Society of Cosmetic Medicine advises against the use of polyalkylimide.
authors.affiliation: Medisch Laser Centrum, Amsterdam, The Netherlands. l.w.schelke@zonnet.nl
authors.forename: Leonie W
authors.initials: LW
authors.lastname: Schelke
authors.forename: Helga J
authors.initials: HJ
authors.lastname: van den Elzen
authors.forename: Marijke
authors.initials: M
authors.lastname: Canninga
authors.forename: Martino H A
authors.initials: MH
authors.lastname: Neumann
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage / Q000009:adverse effects*; D001672:Biocompatible Materials / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005145:Face; D015745:Granuloma, Foreign-Body / Q000139:chemically induced* / Q000453:epidemiology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000139:chemically induced / Q000453:epidemiology; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008863:Microspheres; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012060:Rejuvenation; D012189:Retrospective Studies; D018570:Risk Assessment; D015595:Skin Aging / Q000187:drug effects*; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; C470344:Bio-Alcamid; D001672:Biocompatible Materials; D003879:Dermatologic Agents