Are Permanent Injectable Facial Fillers A Good Idea?

Q:  Hi I was wondering what you think of Bioplasty or have you ever heard of  it. Doctors in Brazil does the whole face with pmma called Newplastique,  injecting it into the jaw, cheeks, chin, eyes, brow anywhere.  I saw a doctor in Mexico who uses this new plastic pmma and he quoted me $2400 for jaw jawline cheeks chin and said second touch up treatment would be half the price. What do you think?

A: What you are referring to are ‘permanent’ injectable fillers for facial fillers and volume enhancement. They are permanent based on that they contain a percent of non-resorbable particles (usually about 30% or less in volume) mixed in with fluids which allow them to be injectable. (flow through a relatively small needle) The percent of particles in any given size syringe is always less than the amount of fluid otherwise they would clog up the needle and not be injectable. There are a variety of these type injectable fillers that exist in the world using different plastic particles and different fluids. The concept, however, is the same and the potential complications are similarly the same.

Quite frankly, I am not a proponent of these type of injectable fillers for widespread facial use. I would be concerned about the potential for long-term problems from the particles such as granulomas and lumpiness. They would be difficult to remove and may have to be cut out should these types of problems arise. Advocates of their use feel that these problems can be minimized by good injection technique, which I am sure is true, but how do you know who does it well and who does it poorly? Around the world, where the medico-legal implications are not as severe, these fillers are more widely used. In the United States, however, their use and many of these type of fillers are not widely done and are not even FDA-approved for use. Nonetheless, It is not an injectable procedure that I feel comfortable doing to patients. That doesn’t make it wrong, just that I have a different practice philosophy.

I feel more comfortable doing enhanced fat injections for facial volume and reshaping. While their permanency is variable, they also are not associated with any long-term complications since it is the patients own tissues. While it is more effort and expense, and may have to be repeated sometimes as well, safety is more important than a lower cost.

Dr. Barry Eppley

Indianapolis Indiana