Mini ReviewOpen Access

Microspheres for Cosmetic and Medical Injections Must be Free of Phagocytosable Microparticles under 20 Microns

Volume 1 - Issue 6

**Gottfried Lemperle¹*, Peter Neugebauer², Ruth Kernke², Karl-Heinz Lerche³ and Stefan Lemperle⁴**

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- ¹1Division of Plastic Surgery, University of California, USA
- ²Medical & Ceramics, Evonik Industriesd AG, Germany
- ³Lerche, Micro Particles GmbH, Berlin, Germany
- ⁴Creative Microspheres, LLC, USA
*Corresponding author: Gottfried L, Division of Plastic Surgery, University of California, San Diego, USA. Home: Wolfsgangstr. 64, D.60322 Frankfurt am Main, Germany

Received: November 01, 2017; Published: November 09, 2017

DOI: 10.26717/BJSTR.2017.01.000512

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Abstract

A more serious complication after the injection of all dermal fillers is the late occurrence of foreign body granulomas. The reason must be the retention of a foreign material in the memory of the macrophages, which likely had phagocytosed it years before a granuloma manifests itself as reddish-blue, dense nodules. This sudden granulomatous immune reaction is probably triggered by a sudden systemic bacterial infection which can be recalled by one-third of all granuloma patients. A vigorous removal of small PMMA particles < 20 μm in the only FDAapproved permanent injectable wrinkle filler ArteFill® and deep dermal injections, have decreased the granuloma rate from 0.5%, experienced with earlier-generation products of Artecoll® in Europe, to 0.01% (4 in 42,000 patients) in China when injected in the deep dermis.

Keywords: Injectable microspheres; Injectable microparticles; PMMA; Foreign body granuloma; Dermal filler

Abbreviations: GERD: Gastro-Esophageal Reflux; SUI: Stress Urinary Incontinence; IDD: Degenerative Disc Disease; SEM: Scanning Electron Microscopy