Synthetic biodegradable hyaluronic acid fillers are widely used as relatively safe injectable methods of lip augmentation but their duration is limited to only four months. Because of this many physicians use alternative non-biodegradable materials like polyacrylamide gels and polyvinyl acid, to create a longer lasting ‘semi-permanent’ product.
Bio in Blue (Polymekon, Brindisi, Italy) is high purity polyvinyl alcohol (8%) and water (92%). Polyvinyl alcohol is a non-toxic substance used in medicine as a drug-carrier and a substitute for human plasma expander.
Retrospective Study of nine cases requiring surgical correction of product migration of semi-permanent lip fillers Bio-Alcamid and Bio in Blue over 2 year period. Nine female patients in otherwise good health were referred to the author by aesthetic doctors in the UK and Ireland with moderate nodular swellings in their labial area over a period of two years. They all reported a history of their
lips having being injected with the cosmetic filler Bio in Blue or Bio-Alcamid at the site of the swelling to correct and project the labial profile.
Four of the patients had previously been injected with another type of HLA filler prior to the use of these semi-permanent type fillers.
The labial swellings were each worsening in appearance as time passed and the patients were emotionally distressed.
Numerous doctors had treated the patients with injections of Dexamethasone (40mgs/ml) or Triamcinolone (40 mg/ml) at intervals, with no resolution of the swelling.
There was no relevant medical history and the patient did not have any clinical evidence of autoimmune or allergic diseases. On palpation, each patient presented with firm longitudinal swellings measuring 3 cm × 2 cm along the lines of filler implant in each patient. The nodules were prominent anteriorly and projected from inside the oral cavity. The patients were all were willing to accept surgical correction and histological evaluation of their problem.
Surgical excisions were carried out by direct use of a size 11 scalpel blade, usually without the use of local anaesthesia, allowing the nodules to point under digital manipulation. The wound was cleaned and the vermillion tissues approximated in some cases with 5-0 Vicryl Rapide sutures (Ethicon, Inc) to achieve closure or haemostatis.
The operation sites healed well and most had healed within few days with no infection. Excision biopsies showed no evidence of foreign body giant cells or irregular crystalline structures and stopped
The wound was cleaned and the vermillion tissues approximated in some cases with 5-0 Vicryl Rapide sutures (Ethicon, Inc) to achieve closure or haemostatis.
The operation sites healed well and most had healed within a few days with no infection. Excision biopsies showed no evidence of foreign body giant cells or irregular crystalline structures and stopped