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Physico Chemical Risk Factors in Complications of Fillers applied to the Body

Abstract : Physico Chemical Risk Factors in Complications of Fillers applied to the Bodydr-alain-tenenbaum-200x200.png

Authors : Alain Tenenbaum, MD.,PhD.,D.Sc-Facial Plastic Surgeon

What delegates will learn /take away from this Presentation

Delegates will learn to be critic vs fillers retailers as companies trainers.

Delegates will learn too how to protect themselves against a patient or a manufacturer in case of medico legal problems and to give arguments to the Judge.

Delegates will learn that FDA or CE is not synonyme of safety. It is just burocraty.


Introduction :

Fillers Body Complications are worse in quality and quantity than Fillers Faces Complications.

Complications are mostly dued to the physico chemical risk factors of the products than bad techniques . Also patients are changing frequently of MD, which make higher the risk of complications for voluntary and/or involontary missing datas in the anamnesis.


None fillers are safe, even if FDA or CE approved.

Any MD will know about questions to ask to the retailers or manufacturers, to complete the anamnesis of a patient asking for fillers with MRN and to know which treatments can be proposed in case of complications in 1, 2 or 3 stages .

Also to face a court in case of medico legal problem, MD will get more weapons to be protected and not accused of malpractice.


Physico chemical Risk Factors belong to the Classification of Fillers Risk Factors by A.Tenenbaum

  • Presence of hydrogel
  • Presence of Monomers
  • Presence of Heavy Metallic Ions
  • Hydrolyse
  • Unstability by Ethylen Oxyde Sterilisation
  • Mixed Biphasic Fillers associating hyaluronic acid or collagene with an acrylate in most cases


  • Hydrogels lead to Geleomas
  • Monomers lead to Migrations
  • Heavy Metallic Ions lead to Migrations and Granulomas
  • Hydrolyse lead to Purulo Necrotic Infections and clinical sign of ,, wet sugar,,
  • Sterilisation with Ethylen Oxide is unstable at the difference of sterilisation with gamma rays where a mapping is important.
  • Mixed Biphasic Fillers are worse than Monophasic Fillers as they associate 2 different fillers like hyaluronic acid or collagene mostly with a long lasting filler of type acrylate.

It is unpossible to remove completely the gel by all methods or number of procedures.


Fillers Body Complications are a non stop nightmare for the patients and their physicians.

Tentatives of Treatments give peaceness for short time until recidives reappear.

The marketing of fillers , especially in commercial events, has hypnotized physicians.

So called ,, key speakers and companies trainers ,, sponsored by pharmaceutical companies never show the complications dued to the products themselves, but only complications related to bad techniques.

Notified Bodies like FDA, CE or others are absolutely not synonym of safety  .

Nothing can replace the experiences of physicians working a lot and seeing the complications , who cannot be accused of technical mistake or malpractise.