The Use of Face Lift Approach for Removal of Permanent Facial Fillers

Background: Over the years facial enhancement andrejuvenation with permanent filler injection have been introduced.Unfortunately, many patients experienced late undesirablecomplications. Such patients present with abnormalskin texture and facial deformities. This may be due to accumulatedfillers or granulomatous reaction to the fillers. Removalof these fillers may be requested by some patients whodeveloped side effects or complications following the injection.Removal of permanent facial fillers is a difficult task as itmay need surgical removal with its hazards.Objective: Is to review the different patients requiringremoval of permanent facial fillers and to demonstrate theauthor''''s experience in utilizing the face lift approach forremoval of these fillers.Patients and Methods: Ninety-three patients with permanentfacial fillers were operated upon. Some of them alreadyhad some complications like infection, granuloma, etc. Whilesome were seeking removal for fear of developing suchcomplications later on. In all patients the classic face liftapproach was used.Results: Fifteen patients had acute facial infection withabscess formation and were treated successfully without anyside effects with complete removal of their fillers. The remaining78 patients had their fillers removed with variabledegrees. Most of the patients had prolonged downtime. Sixtyfivepatients had contour deficits. Ten patients had somecomplications. The encountered complications were facialnerve paresis in six patients, however, four of them recoveredcompletely within a few months after surgery and the othertwo persisted. Another three patients had parotid duct injurybut subsided without any sequel. The last one had persistentswelling of the lower eye lids.Conclusion: Removal of permanent facial filler is a verydifficult task and has many hazards. A special informed consentis designated to include all these hazards should be signed bythe patient. The use of face lift approach is a useful techniquefor removal of permanent facial fillers especially the infectedones. However, the technique is not free from complications.These complications are not related to the technique itself butthey are due to the nature of the presenting pathology.133