title: Massive Hemi-facial Edema After Permanent Filler Removal in an HIV-Positive Patient. Precautions and Patient Information.
abstract: HIV-related lipodystrophy and facial lipo-atrophy are well-described problems stigmatizing many HIV patients. As these patients often require large volumes of filler material, a more permanent solution is necessary. Before the popularization of lipofilling, synthetic permanent fillers have mostly been used. We describe a case report of a patient who had undergone removal of a permanent filler, polyacrylamide gel, because of dislocation of the filler, but who presented a massive hemi-facial edema immediately after the removal. Swelling subsided after 5 days. The use of permanent fillers has diminished due to frequent early and late complications, but a high awareness for permanent filler removal complications remains necessary. Possible pathways to explain these late complications are described.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic and Reconstructive Surgery, University Hospital Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium, zeltzer@doctor.com.
authors.forename: A A
authors.initials: AA
authors.lastname: Zeltzer
authors.forename: B
authors.initials: B
authors.lastname: Craggs
authors.forename: J
authors.initials: J
authors.lastname: Van Thielen
authors.forename: B
authors.initials: B
authors.lastname: Hendrickx
authors.forename: K
authors.initials: K
authors.lastname: Seidenstuecker
authors.forename: M
authors.initials: M
authors.lastname: Hamdi
mesh_terms: D000038:Abscess / Q000209:etiology / Q000628:therapy; D000180:Acrylic Resins / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000009:adverse effects*; D004322:Drainage / Q000379:methods; D004487:Edema / Q000209:etiology* / Q000503:physiopathology; D005145:Face; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology* / Q000628:therapy; D015658:HIV Infections / Q000175:diagnosis; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D019233:Retreatment; D018570:Risk Assessment
chemical_list: D000180:Acrylic Resins; D000067548:Dermal Fillers; C016680:polyacrylamide gels