Anti-wrinkle treatments and cosmetic procedures designed to give women fuller "bee-stung" lips are giving some patients more than they bargained for. New research by the University of Copenhagen has found the fillers plastic surgeons inject into facial tissue can contain infectious bacteria that — in isolated cases — lead to lumps and lesions.
Until recently, injections of fillers were used exclusively for trauma treatment — to rebuild a face disfigured in a traffic accident, for example. But the jelly-like substances are increasingly being used in beauty treatments to erase the effects of aging from the skin.
As a result, side effects in the form of bumps and lesions that do not heal are becoming an increasing problem, the researchers said.
"Previously, most experts believed that the side effects were caused by an auto-immune or allergic reaction to the gel injected," said Morten Alhede, with the university's Department of International Health, Immunology and Microbiology. "Research involving tissue from patients and mouse models has now shown that the disfiguring lesions are actually due to bacteria injected in connection with the cosmetic procedure."
The new findings, published in the journal Pathogens and Disease, also indicate the fillers act as incubators for infection, and only a few bacteria can create an ugly lesion and a tough film of bacterial material that is impossible to treat with antibiotics.
According to the American Society for Aesthetic Plastic Surgery (ASAPS), treatments with products made with hyaluronic acid — such as Restylane — are the second-most popular non-surgical cosmetic procedure in the United States, and their use is rising.
Co-researcher Thomas Bjarnsholt noted some lumps and lesions are treated by cosmetic practitioners with steroids, which can exacerbate the condition.
"The problem will become very serious when the treatment becomes so widespread that people are able to walk in off the street to have their wrinkles smoothed out," he added.
"Experts recommend keeping facial skin free from make-up for a month before undergoing a treatment involving fillers. [But] even when you abide by all the rules and regulations, it is difficult to avoid bacteria completely as they are often buried far below the surface of the skin."
Researchers estimate that as many as one in every hundred patients who undergo such procedures develop an infection, depending on the type of filler used.
"Most people are unlikely to have any problems undergoing a filler treatment to smooth their skin," said Bjarnsholt. "However, it's a bit like driving a car: There's nothing wrong with not wearing your seatbelt as long as you don't hit anything. If you do have an accident, however, it's almost impossible to walk away unharmed."
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