Massive Hemi-facial Edema After Permanent Filler Removal in an HIV-Positive Patient. Precautions and Patient Information

HIV-related lipodystrophy and facial lipo-atrophy are well-described problems stigmatizing many HIV patients. As these patients often require large volumes of filler material, a more permanent solution is necessary. Before the popularization of lipofilling, synthetic permanent fillers have mostly been used. We describe a case report of a patient who had undergone removal of a permanent filler, polyacrylamide gel, because of dislocation of the filler, but who presented a massive hemi-facial edema immediately after the removal. Swelling subsided after 5 days. The use of permanent fillers has diminished due to frequent early and late complications, but a high awareness for permanent filler removal complications remains necessary. Possible pathways to explain these late complications are described. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .