Polyalkylimide Fillers Surgery
Polyalkylimide is a polymer in the family of acryl derivatives. In plastic and reconstructive surgery, surgeons use it for lip augmentation and to build up facial volume in the cheeks, chin and the jaw. Polyalkylimide helps to correct pitted scars, facial folds and furrows. Polyalkylimide is the active ingredient in a permanent dermal filler called Bio-Alcamid, which is a three percent polyalkylimide suspension in water medically used to treat soft tissue deficits such as facial lipoatrophy and lipodystrophy, Poland's syndrome, Pectus excavatum, sunken chest, gluteal atrophy, acne and scars.
Generic name: injectable water-based polyalkylimide gel (4% polyalkylimide, the rest is water)
Brand(s): Bio-Alcamid
Maker / Website: Bio-Alcamid (www.bioalcamid.com) is produced by Polymecon (www.polymekon.it)
Cost: about $150 - $300 per cc depending on treatment volume
Allergy test required: No
Durability: Permanent; can be removed via aspiration although it is unclear how complete such removal may be.
Function / Purpose:
Cosmetic augmentation and reconstruction of the face and body, including treatment of facial lines and folds (e.g. nasolabial folds), lip augmentation, depressed scars, enhancement of cheekbones and jawline, replacement of facial volume lost due to age, lipoatrophy and so forth. Polyalkylimide gel is not indicated for the treatment of fine wrinkles.
Summary:
Injectable water-based polyalkylimide gel contains a small percentage of polyalkylimide (4% in Bio-Alcamid) while the rest is water. In many ways, polyalkylimide gel is chemically and mechanically similar to polyacrylamide gel (Aquamid). However, the manufacturers claim polyalkylimide to have advantages, such as greater stability, better integration with living tissues and simpler removal if required. It is non-biodegradable and the results are considered permanent. The removal requires aspiration and it is unclear how complete such removal may be.
Details:
Injectable water-based polyalkylimide gel contains a small percentage of polyalkylimide (4% in Bio-Alcamid) while the rest is water. Bio-Alcamid is manufactured by Polymekon, Brindisi, Italy. It is used to treat soft tissue deficits like facial lipoatrophy and lipodystrophy, Poland syndrome, Pectus excavatum (sunken chest), gluteal atrophy, etc. In plastic and reconstructive surgery it is used for building up facial volume in areas like the cheeks, chin, jaw and for lip augmentation. It can be used to correct pitted scars, facial folds and furrows (such as nasolabial folds and frown lines) but not fine lines.
In many ways, polyalkylimide gel is chemically and mechanically similar to polyacrylamide gel (Aquamid). However, the manufacturers claim polyalkylimide to have advantages, such as greater stability, better integration with living tissues and simpler removal if required. It is non-biodegradable and the results are considered permanent. The removal requires aspiration and it is unclear how complete such removal may be.
It is injected subcutaneously through a syringe, often under local anesthesia. After the treatment, a thin layer (0.02 mm) of collagen gradually forms around it over a period of 4-8 weeks, completely surrounding the gel, isolating it from the host tissues and making it an endogenous prosthesis. It is radio-transparent (for x-rays), although it can be located by using ultrasound.
Also large quantities can be injected in one session without an immune response. Amounts of 5ml to 20ml are normally injected into the face. Its manufacturer claims that Bio-Alcamid should not degrade or move and that it can also be removed through aspiration or puncture and manual pressure.
While infection is always a possibility with the use of any implanted material, no other major complications have been reported so far. However, long-term safety data are not yet available.
Bio-Alcamid comes in pre-filled syringes (1cc, 3cc and 5cc). Bio-Alcamid has been commercially available since 2000 in Europe and Mexico. The FDA has not yet approved its use in the United States. In Canada it is available under the Special Access Program, which involves application on a patient-by-patient basis.
It is injected under your skin after your doctor delivers a local anesthetic, then it can be molded into place. After the injection, a thin layer of collagen slowly forms around it over the course of about a month. The gel is eventually completely surrounded. A single procedure can inject large volume. This product, which is thought to be quite stable over time, can even be removed if necessary.
Polyalkylimide has another, special use for HIV-positive people who suffer from facial lipoatrophy, also known as facial wasting, which is a side effect of antiretroviral medications. Several studies have found that polyalkylimide is particularly helpful for this condition.
Some of the advantages of polyalkylimide as a dermal filler include:
OBJECTIVES: To evaluate the efficacy, overall esthetic effect, and safety of a new permanent, polyalkylimide dermal filler in HIV-infected patients with severe facial lipodystrophy.
METHODS: Eleven subjects with severe facial lipodystrophy secondary to HIV infection were injected bilaterally with 15 and 30 cm3 of a polyalkylimide gel into the buccal, malar, and temporal areas of the face in an attempt to restore their facial contour. The youngest treated subject was 31 years of age and the oldest 73 years of age.
RESULTS: All 11 subjects received an immediately acceptable therapeutic esthetic effect. Injections were generally well tolerated, with only three adverse events (swelling and bruising) recorded. Subjects, assessed at 3 and 18 months after treatment, continued to show improvement.
CONCLUSIONS: The immediate benefits of a polyalkylimide gel in the correction and restoration of facial contour in subjects having severe HIV-related facial lipodystrophy were demonstrated. This improvement was still noted at 18 months. The efficacy, ease of injection, and safety profile of polyalkylimide gel make this filling material a potentially attractive treatment for lipodystrophy. These data must be tempered with the need for significant further safety studies to determine whether this long-term filler has a safety profile consistent with other currently popular fillers.
Generic name: injectable water-based polyalkylimide gel (4% polyalkylimide, the rest is water)
Brand(s): Bio-Alcamid
Maker / Website: Bio-Alcamid (www.bioalcamid.com) is produced by Polymecon (www.polymekon.it)
Cost: about $150 - $300 per cc depending on treatment volume
Allergy test required: No
Durability: Permanent; can be removed via aspiration although it is unclear how complete such removal may be.
Function / Purpose:
Cosmetic augmentation and reconstruction of the face and body, including treatment of facial lines and folds (e.g. nasolabial folds), lip augmentation, depressed scars, enhancement of cheekbones and jawline, replacement of facial volume lost due to age, lipoatrophy and so forth. Polyalkylimide gel is not indicated for the treatment of fine wrinkles.
Summary:
Injectable water-based polyalkylimide gel contains a small percentage of polyalkylimide (4% in Bio-Alcamid) while the rest is water. In many ways, polyalkylimide gel is chemically and mechanically similar to polyacrylamide gel (Aquamid). However, the manufacturers claim polyalkylimide to have advantages, such as greater stability, better integration with living tissues and simpler removal if required. It is non-biodegradable and the results are considered permanent. The removal requires aspiration and it is unclear how complete such removal may be.
Details:
Injectable water-based polyalkylimide gel contains a small percentage of polyalkylimide (4% in Bio-Alcamid) while the rest is water. Bio-Alcamid is manufactured by Polymekon, Brindisi, Italy. It is used to treat soft tissue deficits like facial lipoatrophy and lipodystrophy, Poland syndrome, Pectus excavatum (sunken chest), gluteal atrophy, etc. In plastic and reconstructive surgery it is used for building up facial volume in areas like the cheeks, chin, jaw and for lip augmentation. It can be used to correct pitted scars, facial folds and furrows (such as nasolabial folds and frown lines) but not fine lines.
In many ways, polyalkylimide gel is chemically and mechanically similar to polyacrylamide gel (Aquamid). However, the manufacturers claim polyalkylimide to have advantages, such as greater stability, better integration with living tissues and simpler removal if required. It is non-biodegradable and the results are considered permanent. The removal requires aspiration and it is unclear how complete such removal may be.
It is injected subcutaneously through a syringe, often under local anesthesia. After the treatment, a thin layer (0.02 mm) of collagen gradually forms around it over a period of 4-8 weeks, completely surrounding the gel, isolating it from the host tissues and making it an endogenous prosthesis. It is radio-transparent (for x-rays), although it can be located by using ultrasound.
Also large quantities can be injected in one session without an immune response. Amounts of 5ml to 20ml are normally injected into the face. Its manufacturer claims that Bio-Alcamid should not degrade or move and that it can also be removed through aspiration or puncture and manual pressure.
While infection is always a possibility with the use of any implanted material, no other major complications have been reported so far. However, long-term safety data are not yet available.
Bio-Alcamid comes in pre-filled syringes (1cc, 3cc and 5cc). Bio-Alcamid has been commercially available since 2000 in Europe and Mexico. The FDA has not yet approved its use in the United States. In Canada it is available under the Special Access Program, which involves application on a patient-by-patient basis.
Here's how it works
Considered a semi-permanent dermal filler, polyalkylimide is a synthetic material often used by plastic surgeons for deeper wrinkles such as nasolabial folds or depressed scars. But it's also helpful to enhance cheekbones and the jawline, and to replace facial volume lost due to age. This type of dermal filler also is a good choice to plump up your lips. Polyalkylimide is not typically used for fine wrinkles.It is injected under your skin after your doctor delivers a local anesthetic, then it can be molded into place. After the injection, a thin layer of collagen slowly forms around it over the course of about a month. The gel is eventually completely surrounded. A single procedure can inject large volume. This product, which is thought to be quite stable over time, can even be removed if necessary.
Polyalkylimide has another, special use for HIV-positive people who suffer from facial lipoatrophy, also known as facial wasting, which is a side effect of antiretroviral medications. Several studies have found that polyalkylimide is particularly helpful for this condition.
Some of the advantages of polyalkylimide as a dermal filler include:
- There is very little reaction with human tissue, meaning it's biocompatible.
- No allergy test is required.
- It's radio transparent, meaning it won't interfere with x-rays.
OBJECTIVES: To evaluate the efficacy, overall esthetic effect, and safety of a new permanent, polyalkylimide dermal filler in HIV-infected patients with severe facial lipodystrophy.
METHODS: Eleven subjects with severe facial lipodystrophy secondary to HIV infection were injected bilaterally with 15 and 30 cm3 of a polyalkylimide gel into the buccal, malar, and temporal areas of the face in an attempt to restore their facial contour. The youngest treated subject was 31 years of age and the oldest 73 years of age.
RESULTS: All 11 subjects received an immediately acceptable therapeutic esthetic effect. Injections were generally well tolerated, with only three adverse events (swelling and bruising) recorded. Subjects, assessed at 3 and 18 months after treatment, continued to show improvement.
CONCLUSIONS: The immediate benefits of a polyalkylimide gel in the correction and restoration of facial contour in subjects having severe HIV-related facial lipodystrophy were demonstrated. This improvement was still noted at 18 months. The efficacy, ease of injection, and safety profile of polyalkylimide gel make this filling material a potentially attractive treatment for lipodystrophy. These data must be tempered with the need for significant further safety studies to determine whether this long-term filler has a safety profile consistent with other currently popular fillers.
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