RESUMO
The lips are essential part of the beauty and attractiveness of the human face. Lip augmentation has become an increasingly used method to improve appearance. Soft tissue fillers are the most commonly used tools. Permanent fillers, however, have been associated with unwanted side effects after lip augmentation. In the present article the present authors will focus on permanent fillers based on polymethylmethacrylate (PMMA). The present authors provide a short review on PMMA fillers and known associated adverse events. The present authors provide a critical review of treatment options. Illustrated by clinical cases The present authors report our preferred treatment of PMMA nodules on lips by intralesional neodymium:YAG laser and blunt suction cannula with or without minor surgery.
Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Granuloma de Corpo Estranho/cirurgia , Terapia a Laser/instrumentação , Lasers de Estado Sólido/uso terapêutico , Lábio/cirurgia , Polimetil Metacrilato/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Estética , Feminino , Granuloma de Corpo Estranho/etiologia , Granuloma de Corpo Estranho/patologia , Humanos , Terapia a Laser/efeitos adversos , Lasers de Estado Sólido/efeitos adversos , Lábio/patologia , Pessoa de Meia-Idade , Polimetil Metacrilato/administração & dosagem , Rejuvenescimento , Fatores de Risco , Sucção , Resultado do TratamentoRESUMO
BACKGROUND: Dermal fillers are widely used for facial and body contouring. Polymethylmethacrylate (PMMA) is a permanent biphasic filler for soft tissue augmentation. In case of unwanted side effects, drug therapy and surgical excision have been commonly used with mixed results. AIM: We report on a series of patients with adverse events to PMMA and an innovative minor invasive procedure to reduce disfigurement by nodules and lumps. METHODS: We employed a subdermal, intralesional 1,064 nm neodymium-doped yttrium aluminium garnet (Nd: YAG) laser in combination with suction using a blunt liposuction cannula of 2.0-2.5 mm of diameter. RESULTS: For 12 years, a total of 81 consecutive subjects (79 females and 2 males) were treated. The average age of the patients was 43.7 years (range 26 to 76 years). Granulomas and lumps could be removed in a minor invasive procedure with tumescent anaesthesia. In a minority of cases, the procedure had to be repeated. The results were impressive and not adverse events related to intralesional laser therapy were observed, 86.4% of patients were satisfied. CONCLUSION: The procedure should be used before or in combination with classical surgery to remove PMMA in case of adverse tissue reactions to PMMA.