Goldman Alberto, Wollina Uwe
Clinica Goldman and Hospital Moinhos de Vento, Porto Alegre, Brazil.
Städtisches Klinikum Dresden, Academic Teaching Hospital Dresden, Department of Dermatology and Allergology, Dresden, Germany.
Open Access Maced J Med Sci. 2018 Sep 23;6(9):1636-1641. doi: 10.3889/oamjms.2018.348. eCollection 2018 Sep 25.
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.
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.
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.
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.
The procedure should be used before or in combination with classical surgery to remove PMMA in case of adverse tissue reactions to PMMA.
真皮填充剂广泛用于面部和身体塑形。聚甲基丙烯酸甲酯（PMMA）是一种用于软组织填充的永久性双相填充剂。在出现不良副作用的情况下，药物治疗和手术切除是常用的方法，但效果不一。
我们报告了一系列使用PMMA出现不良事件的患者，以及一种创新的微创方法，以减少结节和肿块造成的毁容。
我们采用皮下、病灶内1064纳米掺钕钇铝石榴石（Nd:YAG）激光，并结合使用直径为2.0 - 2.5毫米的钝性吸脂套管进行抽吸。
在12年的时间里，共连续治疗了81名受试者（79名女性和2名男性）。患者的平均年龄为43.7岁（范围为26至76岁）。肉芽肿和肿块可以通过肿胀麻醉下的微创方法去除。在少数情况下，该手术需要重复进行。结果令人印象深刻，未观察到与病灶内激光治疗相关的不良事件，86.4%的患者表示满意。
在对PMMA出现不良组织反应的情况下，该手术应在传统手术之前使用或与之联合使用，以去除PMMA。
