Resumo

OLIVEROS, César et al. Disease caused by permanent synthetic fillers FILACP Biomaterials Committee expert group recomendations. Cir. plást. iberolatinoam. [online]. 2022, vol.48, n.3, pp.287-304.  Epub 05-Dez-2022. ISSN 1989-2055.  https://dx.doi.org/10.4321/s0376-78922022000300006.

Disease caused by permanent synthetic fillers (EIRSP acronym in Spanish) represents a real public health problem, especially in Latin America, affecting millions of people, predominantly middle-aged women from a medium-low economic stratum. Currently, there is no consensual therapeutic behavior, the reason that motivated the FILACP Biomaterials Committee 2020-2022 to create a group of 9 experts, who set the following objectives: 1.- Highlight the importance of the disease, 2.- Classify the clinical stages, 3.- Propose a comprehensive diagnosis and treatment protocol, 4.- Propose a multidisciplinary therapeutic strategy and 5.- Promote prevention campaigns.

The most widely used synthetic filler for aesthetic purposes has been silicone injected into the face, buttocks, breasts, lower limbs, hands and genitals, with a high potential for migration. Other substances are methacrylate, mineral oils, paraffin, and a combination. None of these products have a medical grade or are biocompatible. When injected, they will produce various local and systemic reactions triggered by type IV hypersensitivity reactions, leading to the development of autoimmune connective tissue disease.

A classification based on 6 clinical stages or grades is proposed. 1: No signs or symptoms. 2: Color changes. 3: Inflammation, indurations, texture changes, and pain. 4: Extrusion of the product with or without infection. 5: Migration. 6: Severe local or systemic complications.

Diagnostic guidelines are established based on clinical history, laboratory, immunological and radiological tests. For the latter, magnetic resonance imaging is the technique of choice, and in some cases, except for the buttocks and breasts, ultrasound is beneficial.

Care measures and therapeutic guidelines are proposed depending on the clinical grade according to the proposed classification in patients affected by synthetic fillers that compromise the gluteal, lumbosacral, facial, genital, mammary regions, axillary and inguinal nodes and lower limbs.

Palavras-chave : Biopolymers; Permanent fillers; Silicone injection; Polymethyl-methacrylate; ASIA Syndrome.

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