Intralesional Neodymium YAG laser to Treat Complications of Polymethylmethacrylate

BACKGROUND: Dermal fillers are widely used for facial and body contouring. Polymethylmethacrylate (PMMA) is a permanent biphasic filler for soft tissue augmentation. In case of unwanted side effects, drug therapy and surgical excision have been commonly used with mixed results. AIM: We report on a series of patients with adverse events to PMMA and an innovative minor invasive procedure to reduce disfigurement by nodules and lumps. METHODS: We employed a subdermal, intralesional 1,064 nm neodymium-doped yttrium aluminium garnet (Nd: YAG) laser in combination with suction using a blunt liposuction cannula of 2.0-2.5 mm of diameter. RESULTS: For 12 years, a total of 81 consecutive subjects (79 females and 2 males) were treated. The average age of the patients was 43.7 years (range 26 to 76 years). Granulomas and lumps could be removed in a minor invasive procedure with tumescent anaesthesia. In a minority of cases, the procedure had to be repeated. The results were impressive and not adverse events related to intralesional laser therapy were observed, 86.4% of patients were satisfied. CONCLUSION: The procedure should be used before or in combination with classical surgery to remove PMMA in case of adverse tissue reactions to PMMA.