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Bio-Alcamid, the Not So Good Alternative to Fat Grafting

Bio-Alcamid, What Is It?

Well, let me start by saying that it is not a viable alternative to Juvederm or fat grafting. Bio-Alcamid is a polyalkylimide. This is an ingredient used in a permanent dermal filler under the product name Bio-Alcamid, manufactured in Italy. It has gained some interest in the treatment of facial lipoatrophy and lipodystrophy, Poland syndrome, and pectus excavatum (sunken chest). It is often used to build up chin, cheeks, and jaws. However, it is currently non-FDA approved in the United States. I have seen a few patients in the office with complications related to this product that were injected in other countries such as Mexico or Canada. In two cases, I have seen severe infections of the face that required hospitalization. In addition, there are also concerns about product migration. While it is appealing to think that there is indeed a permanent filler out there (and we have seen the failure of silicone injections), this is certainly not a safe product for administration. As it stands, hyaluronic acid such as Restylane and Juvederm appear to be the safest products available for facial fillers outside of fat grafting. However, these products do not last permanently. Radiesse, which is a calcium hydroxyapatite, can last longer up to 8 to 12 months but we are limited to where in the face we can inject this product as it can harden. Therefore, it is really off limits to the lips. Lastly, I have seen patients with silicone injections into the face and into the lips. This is clearly not recommended anymore. The side effects such as granuloma formation and distortion of the soft tissues have been a real problem with this product. In some cases, the patients need to undergo surgery to correct the deformational problems related to silicone injections in the lips. So be careful with what you allow your plastic surgeon to put in your face!

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