Unusual long-term complication of polyalkylimide hydrogel manifesting as nasal septal abscess

Bio-Alcamid is a new synthetic polyacrylic hydrogel that contains alkylimide-amide groups and pyrogen-free water (96%) and has gained widespread use in cosmetic and reconstructive practice since being awarded a Conformite European certificate in 2001. According to the research on the efficacy and safety of the long-acting filler Bio-Alcamid in the early phases of development, Bio-Alcamid is nearly nontoxic and nonallergenic and has long in vivo persistence. It has been widely used because of its superior durability compared with short-acting fillers. Many published studies have examined only early-phase postoperative inflammatory responses. More recently, however, complications with delayed onsets ranging from several months to several years, such as inflammation and filler migration, have been emerging. Given the rapidly increasing application of long-term fillers, an increased incidence of complications is expected, and increasing awareness of its correct use and complication treatments is needed. To address this problem, we reviewed the safety of long-acting fillers on the basis of a rare case of surgical incision and drainage of a nasal septal abscess that developed in a patient 2 years after Bio-Alcamid was injected into the nasal region.