Thursday, 22 March 2018

Correcting Problems with Permanent Lip Fillers

Have you had a lip enhancement with permanent filler? Did it look fine initially but now you’re experiencing problems?

Late-onset complications with permanent filler injections are not uncommon and can be difficult to treat, however an eight-year study by Ocean Clinic Marbella gives fresh hope to those suffering.

The study looked at the best way to remove the filler and reconstruct the lips. It involved 11 patients who had received Aquamid injections between 2-10 years previously (not at Ocean Clinic). It has now been published in the highly respected medical journal, Aesthetic Plastic Surgery.

Common Complications with Permanent Lip Filler

Polyacrylamide hydrogel (branded Aquamid) has been in use as a permanent filler since 2001. It is considered inherently safe, however problems can occur later on after apparently successful implantation.  

Migration - that is filler moving from its original position - is a common complication, which can develop even years after the injection. In the patients treated by Ocean Clinic’s Head Surgeon Dr. Kaye and his team, migration was seen in the mucosa, which is the membrane lining of the lips and also in the facial skin around the lips.

The filler was visible as yellowish accumulations; lumps and bump, leading to general unevenness and asymmetry of the lips. This was exacerbated by fibrosis (excess scar tissue forming around the filler).

These problems resulted in not only an undesirable aesthetic but also pain, tenderness and - in two patients - infection. One patient also suffered with a burning sensation in their upper lip.

Fixing Issues with Permanent Lip Filler

Because it is not possible to aspirate the filler  (remove through suction) in cases where it has diffused different skin layers, surgery is the only option. Dr. Kaye used a lip reduction technique known as the ‘bikini reduction’ - so called because of the shape of the incisions (see below diagram).

Says Dr. Kay: “Through the bikini access, the gel and the surrounding scar tissue were removed by sharp scissor dissection. Complete dissection of muscle and mucosa had to be performed to excise the majority of the polyacrylamide gel.

“Because the product extended in most cases into the mucosa and musculature, leading to volume loss after removal, individual modifications of the described technique had to be performed to give the upper lip the favorable shape of an M and the lower lip the shape of a W, while maintaining a good volume relationship between the lips.”

In order to restore volume to the lips and create the best aesthetic result possible, fat was taken from patients’ abdomens and transplanted into their lips, in eight out of the 11 cases.

The Results

Dr. Kaye and his team removed as much of the Aquamid deposits as possible from all 11 patients, however residues of the gel close to the mucosa had to be left in eight cases to avoid compromising the blood supply.

The majority of the patients declared themselves to be satisfied or very satisfied with the aesthetic result one year after the initial operation.

The shape of the patients’ lips were observed by two independent plastic surgeons after one-year postoperatively and no dynamic asymmetries were detected. The patients who had fat transfer to the lips continued to have satisfactory volume.

Concludes Dr. Kaye: “Volume reduction and restoration of a harmonic relation between the upper and lower lips can be achieved using a modified bikini technique.

“Autologous fat grafting to the lips is a useful tool to correct volume deficits and asymmetries and can often be performed successfully within a single-stage operative session.”

Want your permanent lip filler removed? Contact Ocean Clinic for a consultation on 951 775 518.

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