Fillers have become the rage in plastic surgery but, those seeking fewer facial lines, fuller lips or “plumping” in other areas should be aware that fillers are not without risk.

A new article in Plastic and Reconstructive Surgery, the journal of the American Society of Plastic and Reconstructive Surgery demonstrates just this. Complications from the fillers containing polymethylmethacrylate were reported by a group of Brazilian surgeons. These fillers are available in the US under the names ArteFill and Artecoll. The purported benefit of these products is their permanence – everyone wants fewer trips to the doctors office – but the side effects make this decision one with significant risks.

In this article, thirty two patients with complications were reported. This number represents a very small fraction of the number of patients treated in Brazil and around the world with these products but, the magnitude of the problems was a cause for concern. Complications ranged in severity from location inflammatory changes to frank skin loss. Many of the patients developed nodules under the skin (granulomas) which were easy to feel and painful. Treatment of these complications was not straight forward and patients often sustained permanent scarring, swelling or chronic infection.

This article shouldn’t scare those seeking a quick fix from a filler as much as it should show them the importance of educating themselves before going “under the needle”. Injectables seem like no-brainers – after all now a days every spa in town is offering treatments. Patients need to understand that when they entrust themselves to doctors, nurses or aestheticians without plastic surgical education and training they take on a real risk that may effect them long after the treatment.

Asking questions about the filler is invaluable. Not only “how long does it last?” but also “what are the complications?”, “how are the complications treated?” and “why are you selecting this filler over others for me?” are all reasonable questions of any practitioner. Failure to give understandable answers should be a reason to reconsider.