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Research Article| Volume 65, ISSUE 12, P1622-1626, December 2012

Patient satisfaction following Bio-Alcamid injection for facial contour defects

  • D.A. George
    Correspondence
    Corresponding author.
    Affiliations
    Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, UK
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  • E. Erel
    Affiliations
    Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, UK
    Search for articles by this author
  • R. Waters
    Affiliations
    Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham, UK
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      Summary

      Bio-Alcamid, a polyalkylimide gel, can be injected into subcutaneous tissue as an endoprosthesis for correcting contour deformities and soft tissue defects. We have reviewed its facial uses and longer-term outcomes over a 7-year period, including a patient satisfaction survey. 69 patients were included in the study, 89.9% undergoing treatment secondary to HIV-associated facial lipoatrophy. 55.0% of patients responded to questionnaires: 52.5% experienced severe pain associated with injections, and 50.0% experienced at least one complication (migration, hardening, irregularity). 94.4% stated an improvement in their cheek volume, 77.8% would undergo the procedure again, and 86.1% would recommend the treatment to a friend. Despite the relatively high patient satisfaction, we no longer recommend this treatment to our patients for cosmetic indications, due to significant long-term complication rates.

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      References

        • Bacchetti P.
        • Gripshover B.
        • Grunfeld C.
        • et al.
        Fat distribution in men with HIV infection.
        J Acquir Immune Defic Syndr. 2005; 40: 121-131
        • Gopinath R.
        • Hutcheon M.
        • Cheema-Dhadli S.
        • Halperin M.
        Chronic lactic acidosis in a patient with acquired immunodeficiency syndrome and mitochondrial myopathy: biochemical studies.
        J Am Soc Nephrol. 1992; 3: 1212-1219
        • Kitahata M.M.
        • Gange S.J.
        • Abraham A.G.
        • et al.
        Effect of early versus deferred antiretroviral therapy for HIV on survival.
        N Engl J Med. 2009; 360: 1815-1826
        • Nguyen A.
        • Calmy A.
        • Schiffer V.
        • et al.
        Lipodystrophy and weight changes: data from the Swiss HIV cohort study, 2000–2006.
        HIV Med. 2008; 9: 142-150
        • Guaraldi G.
        • Fontdevila J.
        • Chritensen L.H.
        • et al.
        Surgical correction of HIV-associated facial lipoatrophy. Editorial review.
        AIDS. 2011; 25: 1-12
        • Nelson L.
        • Stewart K.J.
        Early and late complications of polyalkkylimide gel (Bio-Alcamid).
        JPRAS. 2011; 64: 401-405
        • Treacy P.J.
        • Goldberg D.J.
        Use of a biopolymer polyalkylimide filler for facial lipodystrophy in HIV-positive patients undergoing treatment with antiretroviral drugs.
        Dermatol Surg. 2006; 32: 804-808
        • Honig J.F.
        Cheek augmentation with Bio-Alcamid in facial lipoatrophy in HIV seropositive patients.
        J of Cranioial Surg. 2008; 19: 1085-1088
        • Lahiri A.
        • Waters R.
        Experience with Bio-Alcamid, a new soft tissue endoprosthesis.
        JPRAS. 2007; 60: 663-667
        • Protopapa C.
        • Sito G.
        • Caporale D.
        • Cammarpta N.
        Bio-Alcamid in drug-induced lipodystrophy.
        JCosLasThe. 2003; 5: 226-230
        • Christensen L.
        Normal and pathologic tissue reactions to soft tissue gel fillers.
        Dermatol Surg. 2007; 33: 168-175
        • Schelke L.W.
        • van Den Elzen H.J.
        • Canninga M.
        • Neumann M.H.A.
        Complications after treatment with polyalkylimide.
        Dermatol Surg. 2009; 35: 1625-1628
        • Adam R.H.
        • Malhotra R.
        Long-term complications orbitofacial of Polyalykylimide 4% (Bio-Alcamid).
        Ophth Plast Recon Surg. 2009; 25: 394-397
        • Ramon Y.
        • Lucian F.
        • Ullman Y.
        Preliminary experiences with Bio-Alcamid in HIV facial lipoatrophy.
        Dermatology. 2007; 214: 151-154
        • Shackelford T.K.
        • Larsen R.J.
        Facial asymmetry as an indicator of psychological, emotional, and physiological distress.
        J of Personality and Social Psychology. 1997; 72: 456-466
        • Jones D.H.
        • Carruthers A.
        • Fitzgerald R.
        • et al.
        Late-appearing abscesses after injections of nonabsorbable hydrogel polymer for HIV-associated facial lipoatrophy.
        Dermatol Surg. 2007; 33: 193-198
        • Karim R.B.
        • Hage J.J.
        • van Rozelaar L.
        • et al.
        Complications of polyalkylimide 4% injections (Bio-Alcamid): a report of 18 cases.
        JPRAS. 2006; 59: 1409-1414
        • Goldan O.
        • Georgiou I.
        • Grabov-Nardini G.
        • et al.
        Early and late complications after a nonabsorbable hydrogel polymer injection: a series of 14 patients and novel management.
        Dermatol Surg. 2007; 33: 199-206
        • Loufty M.R.
        • Raboud J.M.
        • Antoniou T.
        • et al.
        Immediate versus delayed polyalkylimide gel injections to correct facial lipoatrophy in HIV-positive patients.
        AIDS. 2007; 21: 1147-1155
        • Karim R.B.
        • de Lint C.A.
        • van Galen S.R.
        • et al.
        Long-term effect of polyalkylimide gel injections on severity of lipoatrophy and quality of life.
        Aesthetic Plastic Surgery. 2008; 32: 873-878
        • Coleman S.R.
        Facial recontouring with lipostructure.
        Clin Plast Surg. 1997; 24: 347-367
        • Caye N.
        • Le Fourn B.
        • Pannier M.
        Surgical treatment of facial lipoatrophy.
        Ann Chir Plast Esthet. 2003; 48: 2-12
        • Strauch B.
        • Baum T.
        • Robbins N.
        Treatment of human immuno- deficiency virus-associated lipodystrophy with dermafat graft transfer to the malar area.
        Plast Reconstr Surg. 2004; 113: 363-370
        • Burnouf M.
        • Buffet M.
        • Schwarzinger M.
        • et al.
        Evaluation of Coleman lipostructure for treatment of facial lipoatrophy in patients with human immunodeficiency virus and parameters associated with the efficiency of this technique.
        Arch Dermatol. 2005; 141: 1220-1224