Background: Over the years facial enhancement and
rejuvenation with permanent filler injection have been introduced.
Unfortunately, many patients experienced late undesirable
complications. Such patients present with abnormal
skin texture and facial deformities. This may be due to accumulated
fillers or granulomatous reaction to the fillers. Removal
of these fillers may be requested by some patients who
developed side effects or complications following the injection.
Removal of permanent facial fillers is a difficult task as it
may need surgical removal with its hazards.
Objective: Is to review the different patients requiring
removal of permanent facial fillers and to demonstrate the
author''''s experience in utilizing the face lift approach for
removal of these fillers.
Patients and Methods: Ninety-three patients with permanent
facial fillers were operated upon. Some of them already
had some complications like infection, granuloma, etc. While
some were seeking removal for fear of developing such
complications later on. In all patients the classic face lift
approach was used.
Results: Fifteen patients had acute facial infection with
abscess formation and were treated successfully without any
side effects with complete removal of their fillers. The remaining
78 patients had their fillers removed with variable
degrees. Most of the patients had prolonged downtime. Sixtyfive
patients had contour deficits. Ten patients had some
complications. The encountered complications were facial
nerve paresis in six patients, however, four of them recovered
completely within a few months after surgery and the other
two persisted. Another three patients had parotid duct injury
but subsided without any sequel. The last one had persistent
swelling of the lower eye lids.
Conclusion: Removal of permanent facial filler is a very
difficult task and has many hazards. A special informed consent
is designated to include all these hazards should be signed by
the patient. The use of face lift approach is a useful technique
for removal of permanent facial fillers especially the infected
ones. However, the technique is not free from complications.
These complications are not related to the technique itself but
they are due to the nature of the presenting pathology.
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