As plastic surgeons we seek new innovative technologies which can avoid major surgical procedures. But, massive volume injections of fillers seem to have a rate of complications that are unacceptable. Migration, entering the blood supply, and toxicity, can cause serious problems. We had a death in our community from the hydrogel injected into the buttocks of a person going in for a massage and buttocks augmentation, by a lay massage practitioner. This death has been under investigation for quite some time. A final coroner's report is forthcoming. Calls to our office from young women revealed by name and appearance, vials of hydrogel (that were curiously similar) to the brands discussed in this forum). In one case the consumer knew someone who would come to the house and inject the gel (clearly a PMMA product by its name description) for $3000. When asking where that lay injector got the gel, one consumer said they obtained it from a doctor. The manufacturer of one of these products ask that I modify my comments in this thread since it might raise concerns over its reputation as a producer of one form of these hydrogels. A few places worldwide produce the hydrogels and they are distributed in massive quantities for use everywhere. I agree that quality control may vary between manufacturers, however the early and late problems with large volume hydrogel/methacrylate soft tissue fillers can not overstated. As a board certified plastic surgeon who is reporting consequences (instead of an unsuspecting consumer who is presenting with consequences), it would be more damaging to a manufacturer if the professional made the linkage of cause and effect. In this country, when such safety issues are raised the FDA looks into things, and action is taken. I would hope that any foreign manufacturers of products and pharmaceuticals continue to receive the same scrutiny from their respective oversight authorities, particularly when a problem in distribution or the implementation of their product is brought to light in another countryEveryone should consider these warnings about fillers of the hydrogel variety. I am sure you will find someone outside the US to do it. For now, don't. Best wishes.
