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Removal of Polyacrylamide Gel (Aquamid®) from the Lip as a Solution for Late-Onset Complications: Our 8-Year Experience

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  • Facial Surgery
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Abstract

Background

The polyacrylamide hydrogel Aquamid® has been used as a permanent filler to enhance facial soft tissue volume and correct wrinkles since 2001. Various long-term studies have proved the safety of the product. Nonetheless, if complications such as migration occur, they can be difficult to treat.

Methods

Eleven patients suffering from late-onset complications after taking Aquamid® injections in the lips underwent product removal and subsequent labial reconstruction between 2009 and 2017. The reconstruction was performed using a modified bikini reduction technique combined, in eight cases, with immediate autologous fat grafting.

Results

In all the patients, general fibrosis and a diffused distribution of the product within all three layers of the lips resulted in the need for labial reconstruction. Migration, as far as in the mucosa and perioral skin, accounted for macroscopically visible yellowish accumulations. In ten out of eleven cases, an individually modified bikini reduction technique, with or without any combination of autologous fat grafting, led to an esthetically satisfying result. One patient developed a severe upper lip necrosis.

Conclusion

Contradictory to several previous studies attesting to the lack of migration after Aquamid® application to the lips, capsule formation around the product is impaired, allowing for migration even years after the injection. Product aspiration is not possible in these cases, thus necessitating complex lip reconstruction. Bikini reduction and fat grafting are valuable tools for labial reconstruction. Product residuals within the mucosa have to be accepted. Special care has to be taken while treating smokers.

Level of Evidence IV

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.

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Authors and Affiliations

  1. Center for Plastic and Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain

    Sonja Kästner, Felix Paprottka & Kai O. Kaye

  2. Department for Otolaryngology, Head and Neck Surgery, Eberhard Karls University Tuebingen, Tübingen, Germany

    Phillipp Gonser

Authors
  1. Sonja Kästner
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  2. Phillipp Gonser
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  3. Felix Paprottka
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  4. Kai O. Kaye
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Correspondence to Sonja Kästner.

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The authors declare that they have no conflict of interest.

Human and Animal Participants

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

All participants gave their informed consent in writing for their inclusion in this retrospective, clinical case study.

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Kästner, S., Gonser, P., Paprottka, F. et al. Removal of Polyacrylamide Gel (Aquamid®) from the Lip as a Solution for Late-Onset Complications: Our 8-Year Experience. Aesth Plast Surg 42, 791–797 (2018). https://doi.org/10.1007/s00266-018-1114-1

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  • DOI: https://doi.org/10.1007/s00266-018-1114-1

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