Facial Biopolymers and Main Imaging Findings with Their Potential Complications: A Contemporary Review
Authors
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Abstract
The use of injectable fillers in the facial region has grown significantly in recent decades, primarily for aesthetic rejuvenation and for the treatment of facial lipoatrophy. These procedures employ a wide range of materials, including temporary fillers (such as hyaluronic acid or poly-L-lactic acid) and permanent fillers (such as calcium hydroxyapatite, collagen, liquid silicone, polytetrafluoroethylene, or polyacrylamide gel).
Although these materials are often detected incidentally in imaging studies-raising the challenge of avoiding confusion with pathological lesions-patients may also require radiologic evaluation to identify associated complications. The most frequent complications include infection, overfilling, material migration, foreign-body reactions, and fibrosis or scarring. In this regard, it is essential to be familiar with the specific imaging characteristics of each biopolymer and its potential complications, thus facilitating accurate diagnosis and timely clinical management.
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Copyright (c) 2025 Fabiana Nicole Muñoz Bolaños, Carlos Andrés Chango Rodríguez, Dra. Elena Escobar, María Belén Veloz Espinoza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Fabiana Nicole Muñoz Bolaños, School of Medicine, UDLA University, Quito, Ecuador.
School of Medicine, UDLA University, Quito, Ecuador.
Carlos Andrés Chango Rodríguez, School of Medicine, UDLA University, Quito, Ecuador.
School of Medicine, UDLA University, Quito, Ecuador.
Dra. Elena Escobar, Radiology- CETCUS, Ecuador.
Radiology- CETCUS, Ecuador.
María Belén Veloz Espinoza, School of Medicine, UDLA University, Quito, Ecuador.
School of Medicine, UDLA University, Quito, Ecuador.
[1] Kontis TC, Rivkin A. The history of injectable facial fillers. Facial Plast Surg 2009;25:67-72
[2] Di Girolamo M et al (2015) MRI in the evaluation of facial dermal fillers in normal and complicated cases. Eur Radiol 25(5):1431-1442
[3] Persichetti P et al (2013) Dermal filler complications from unknown biomaterials: identification by attenuated total reflectance spectroscopy. Plast Reconstr Surg 131(4):597e-603e
[4] Feeney JN, Fox JJ, Akhurst T (2009) Radiological impact of the use of calcium hydroxylapatite dermal fillers. Clin Radiol 64(9):897-902
[5] Ridenour B, Kontis TC. Injectable calcium hydroxylapatite microspheres (Radiesse). Facial Plast Surg 2009;25:100 -05
[6] Ginat DT, Schatz CJ. Imaging features of midface injectable fillers and associated complications. AJNR Am J Neuroradiol. 2013 Aug;34(8):1488-95. doi: 10.3174/ajnr.A3161.
[7] Saray A. Porcine dermal collagen (Permacol) for facial contour augmentation: preliminary report. Aesthetic Plast Surg 2003;27:368 -75
[8] Monheit, G. D., & Coleman, K. M. (2006). Hyaluronic acid fillers. Dermatologic Therapy, 19(3), 141-150.
[9] Gold, M. H. (2007). Use of hyaluronic acid fillers for the treatment of the aging face. Clinical Interventions in Aging, 2(3), 369-376. https://doi.org/10.2147/cia.s1128
[10] Carruthers, J., Fagien, S., & Rohrich, R. J. (2005). Filler materials for facial rejuvenation: A systematic review. Plastic and Reconstructive Surgery, 116(3), 73S-83S.
[11] Vleggaar, D. (2005). Soft-tissue augmentation and the role of poly-L-lactic acid. Aesthetic Surgery Journal, 25(5), 489-493.
[12] Verpaele A, Strand A. Restylane SubQ, a non-animal stabilized hyaluronic acid gel for soft tissue augmentation of the mid- and lower face. Aesthet Surg J 2006;26:S10 -17
[13] Christensen, L., Breiting, V., Aasted, A., Jørgensen, A., & Kebuladze, I. (2006). Long-term effects of polyacrylamide hydrogel in human breast tissue. Plastic and Reconstructive Surgery, 118(1 Suppl), 7S-16S.
[14] Reda-Lari A. Augmentation of the malar area with polyacrylamide hydrogel: experience with more than 1300 patients. Aesthet Surg J 2008;28:131-38
[15] Sturm LP, Cooter RD, Mutimer KL, et al. A systematic review of dermal fillers for age-related lines and wrinkles. ANZ J Surg 2011;81:9 -17