Virginia Facial Plastic Surgery Blog

Hi,

In the US, we have no experience with Aquamid.  As a permanent filler, it is somewhat similar to Artefill.  Its not a solid implant for it to be shaved or modified.  Removing any of it will result in removal of someof your own normal tissue as well.  surgery in the area can risk infecting the material as well making it an even bigger problem.  That is precisely why I do not recommend injection of large amounts of permanent fillers in the cheeks and would rather see patients get Hyaluronic acid fillers like Perlane, silicone cheek implants or fat injection.  I would check with doctors in Europe and Asia and see what their experience is with modifiying or "shaving" Aquamid.

Hi,

It is nearly impossible to remove an injectable filler completely.  Permanent or non permanent fillers are not like discreet implants and complete removal is almost impossible.

I have said it for a long time now:  Non surgical rhinoplasty is only a viable option if it can be done with small amounts of safe temporary hyaluronic acid based fillers like Juvederm or Restylane, etc.

Artefill, Aquamid, Silicone, etc have no business in the nose and should be avoided at all costs.

You should talk to some very experienced Rhinoplasty surgeons to be examined and see if a Rhinoplasty would be recommended.  Often we can perform Rhinoplasty on patients in your situation but usually the fillers and their scar tissue have to be removed at the time of surgery and Temporalis fascia or Alloderm need to be used to provide some soft tissue cushion.  You have options but your case is complex and you should seek an experienced specialist.

Hi Douglas,

I hope you are not in the U.S.A., because Aquamid is illegal in the U.S. and it is not an FDA approved substance.  Regardless, what is done is done.  Aquamid is a permanent particulate filler.  As such infection is possible even by itself.  People can get infections of their skin with just a plain needle penetration.  In such situations, antibiotics often clear up the infection quickly.  When there is an implant (and a permanent filler is a kind of implant) then any bacteria can adhere to the material and sometimes its very difficult for antibiotics alone to clear up the infection.

So basically, Restylane on top of Aquamid in theory is fine.  But it does SLIGHTLY increase the risk of infection.  You have to make that final decision. 

If you would like to send me some pictures through the "contact us" page then I may be able to give you other suggestions - perhaps.  I would recommend you see a few other local docs and discuss options. 

Supposedly Aquamid can be removed with dilution and aspiration although I have never seen that.

Good luck