Long-term orbitofacial complications of polyalkylimide 4% (bio-alcamid).
OBJECTIVE
To review our experience with the long-term orbitofacial complications of polyalkylimide 4% (Bio-Alcamid), including migration, infection, and recurrent swelling.


METHODS
A retrospective case series of 4 patients who received preperiosteal polyalkylimide 4% filler treatment: 3 patients received treatment to cheeks and/or nasolabial folds and 1 received treatment to the tear-trough region. All 4 patients were referred with delayed complications.


RESULTS
Four patients presented with the unusual delayed complications of infection including abscess formation, migration of filler, recurrent swelling, and inflammatory nodules.


CONCLUSIONS
Because of the hydrophilic and endoprosthetic nature of polyalkylimide 4%, migration of the product is unexpected. We hypothesise that in our patients, filler migration occurred after bimanual expression and/or manipulation of the product with disruption of the surrounding collagen capsule. Because removal of polyalkylimide 4% is only achieved via aspiration and bimanual expression, which itself may precipitate long-term migration of the product, it is vital that clinicians are mindful of these complications and the pitfalls of overfill and misplacement of the product, for informed patient consent.
Ross
Adam H
AH
Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, Sussex, United Kingdom.
Malhotra
Raman
R
D000038:Abscess / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D000180:Acrylic Resins / Q000009:adverse effects*; D003357:Cosmetic Techniques; D004487:Edema / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005148:Facial Dermatoses / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D015745:Granuloma, Foreign-Body / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D015595:Skin Aging; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
D000180:Acrylic Resins; C470344:Bio-Alcamid