Complications from Injectable Polyacrylamide Gel, a New Nonbiodegradable Soft Tissue Filler:

Nonthrombotic Pulmonary Embolism: A Potential Complication of Polyacrylamide Hydrogel Cosmetic Injection

Context. Polyacrylamide hydrogel (PAAG) has gained importance as a synthetic soft tissue filling agent. It has been commonly employed by physicians in Europe for facial contouring and soft tissue augmentation. Previously, PAAG is considered nontoxic and well tolerated with a few mild procedural complications. Case Presentation. A 26-year-old female was hospitalized for dry cough, worsening dyspnea, and chest discomfort after 3 hours of multiple PAAG injections in buttocks. The patient's condition deteriorated and rapidly advanced to acute respiratory failure. Therein, the diagnosis of nonthrombotic pulmonary embolism (NTPE) was established on standard set of investigations. She was intubated; corticosteroid and empiric antibiotic therapy was initiated resulting in improvement of her condition. Subsequently, extubation was done, and she was discharged from the hospital after an uneventful recovery. On 1-month follow-up, the patient had no previous symptoms. Conclusion. This report implicates clinicians to maintain a high index of suspicion for NTPE in patients presenting with respiratory symptoms following PAAG usage.

Facial gel complication after dental injection: a case report

Injectable gel is becoming increasingly popular for cosmetic reasons. The polyacrylamide gel (PAAG) is a permanent filler material used worldwide. In spite of the fact that the filler materials used today are considered quite safe, various complications have been reported in the literature. Hence PAAG use in the United States is not popular. As the area is very close to the dental field, a large complication potential is relatively considered following buccal dental injections. The aim of this article is to highlight a rare complication observed following a local anesthetic administration of a simple molar restoration in a healthy 33-year-old woman who had history of a filler augmentation in her cheek approximately 6 years ago.

Contouring of the gluteal region in women: enhancement and augmentation

Techniques for improving the appearance of the gluteal region are important elements in body contouring. In all cultures and communities, this aspect of the physique holds a special place among the elements comprising the ideals of physical beauty. Recent studies described the aesthetics of the gluteal region in terms of shape, volume, and projection. Accumulation of fat at the supragluteal, lower paralumbar, infragluteal, and/or trochanteric areas often disturbs the natural shape of the buttocks. The problem is accentuated by the lack of lateral projection. This study was designed to find a method for contouring of the gluteal region. This method is based on the enhancement of the shape by liposculpture of the areas around the buttocks, and lipoinjection to achieve the volume and projection. Between July 2008 and December 2009, the study included 40 female patients complaining of disfigurement of the gluteal region. With 1 year follow-up period, 36 patients showed high satisfaction with the results. Pre- and postoperative perimeters of the gluteal regions showed good improvement in proportion and projection. The study concluded that liposuction of the areas around the buttocks could enhance the shape of the gluteal region. Lipoinjection could add a balanced shape, size, and projection. A pleasing gluteal appearance could be achieved by the combination of enhancement and augmentation.

Buccal reaction to silicone cosmetic filler

BACKGROUND

Administering injections of dermal fillers has become a popular office procedure that is performed to restore facial volume, augment facial volume or both. Injectable silicone is a nonbiodegradable filler that was introduced 40 years ago. Adverse reactions can develop from its long-term presence in the body.

CASE DESCRIPTION

The authors evaluated a 45-year-old woman who nine years previously had received bilateral silicone cosmetic filler injections in the malar regions of her face. Two years and again five years later, she developed painless buccal swellings on the right side of her face, but the condition regressed spontaneously. When a third episode of right buccal swelling persisted, she sought care. Therapy involving the use of antibiotic agents and steroids resolved the patient's reaction to the silicone, but the pathophysiology of the reaction has not been delineated clearly.

CONCLUSION AND CLINICAL IMPLICATIONS

Dental practitioners may see orofacial inflammatory swellings initiated by a reaction to silicone. Differentiating it from facial cellulitis is essential. Practitioners should base their diagnoses of orofacial inflammatory swellings on patients' history of receiving injectable cosmetic filler.