Would biofilm form around fat?

Question

Hi. I've had a confirmed biofilm in my face. My doctor injected it with saline when it appeared to go away. An abscess formed that needed to be cut out. He injected with saline again, when nothing happened, he tried Juvederm again. I now have another biofilm I've tried to dissolve many times with Hylenex. When this appears to go away, or go dormant, would a fat injection be safe or could a biofilm form around that, too? I know they form around foreign objects, but HA is in us as well.

Hung William Song, MD · Answer

This is a great question. I have performed about thousand fat transfers over my career and I have not seen biofilm form around fat. That is not to say it couldn't form around fat, just that it is unlikely. Then again, I have preformed several thousand filler injections and have only seen 2 cases of biofilm. The reason biofilm forms around a foreign object is because your immune system cannot get to it. You need a blood supply to the area for your immune system to fight the community of bacteria that find sanctuary on the foreign object. Because a fat transfer implants living tissue and the implanted cells get their own blood supply, an infection that forms on the fat cells can be fought off by your immune system. Although hyaluronic acid is a substance that is normally found in our bodies, a bolus of HA injected into you does not get its own blood supply so bacteria can hide in there. An improperly performed fat transfer can form an infection because if you put too much fat in, the center of the implanted fat will not get a blood supply and bacteria can fester in there causing an abscess. Since you have had biofilm form and it is difficult to completely eradicate, I would not recommend any more fillers and even a fat transfer could be risky. You might want to consider a PRP treatment or a PRP gel treatment like AutoCorre. PRP has antibacterial qualities and sends a signal to stimulate creation of new collagen and blood supply. The gel dissolves away so you don't have the risk of a biofilm forming on it. Also, make sure you go to an injector who is very diligent about sterile technique.

Anna Chacon, MD, FAAD · Answer

Biofilms are complex communities of bacteria that can adhere to surfaces and are often resistant to conventional treatments. They typically form around foreign materials introduced into the body, such as implants or fillers, particularly if the material remains in the body for an extended period.

Regarding your question about fat injections, fat is an autologous material, meaning it comes from your own body, which generally reduces the risk of biofilm formation compared to synthetic materials. However, any procedure that involves injections or implants carries a risk of infection, which can potentially lead to biofilm formation if bacteria are introduced during the procedure.

Given your history of biofilm formation with previous treatments, it is crucial to discuss this concern thoroughly with your healthcare provider. They can evaluate your specific situation, consider your medical history, and determine the safest and most effective treatment options for you. It might also be beneficial to consult with a specialist in infectious diseases or a dermatologist with experience in managing complex cases involving biofilms.

Ensure that any procedure is conducted in a sterile environment and that all necessary precautions are taken to minimize the risk of infection. Your healthcare provider can also discuss alternative treatments and preventive measures tailored to your needs.

Eric M. Joseph, MD · Answer

Biofilm formation is an indolent infection that is associated with hyaluronic acid, a sugar molecule. Since fat is not a sugar, I do not believe that biofilm is associated with lipotransfer. Great question. I wish you well moving forward. Sincerely, Dr Joseph

Would biofilm form around fat?

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Would biofilm form around fat?

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Our mission is to create a world where every investment in modern beauty is Worth It.