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I recently posted to the body.com's new ask the experts site on facial wasting.. I told the doc that about 7% of pts have infection issues and he is asking where i got this 7% from.. I don;t remember for sure,. but i think someone on this list mentioned the 7%. I have enclosed my statemnt and the docs response.. If we think that BA is no longer 1st line treatment. pls write to the doc or tell me what to write about the 7% infection rate or the correct infection %. Here is my post:

Bio alcamid and risk of infectionMay 2, 2008

Many of us have had this agent injected in Tijuana. There, the product is no longer used as there are better agents to use, pmma.. The problem with bioalcamid is that is causes encapsulated sacs and about 7% of pts have severe infections if the sacs are disturbed from surgery ,dental work,trauma. etc.. For more info.. pls direct your members to facialwasting.org There you will get all the info you need to make informed decisions..

Response from Dr. Pierone Hello, and thanks for posting.

The issue with late infections of Bioalcamid implants is a legitimate concern. Do you have a reference or a source for the 7% rate of severe infections? The magnitude of this problem is not well documented. The overall infection rate (early and late) in Toronto (personal communication - Dr. Beninger) is less than one percent in over 2000 treated patients.

Bioalcamid is encapsulated after injection and represents a permanent implant. If infection develops, the severity will depend on the virulence of the infecting organism and the immune status of the infected individual. Mild infections may be treated with oral antibiotics alone. For moderate or severe infections some the implant will need to be punctured and infected material drained through the puncture site. In severe infections intravenous antibiotics may be necessary. After the infection has cleared up and at least several months have passed a restorative implant can be considered.

I have seen infected surgical facial implants and a similar management approach is used, although the implant almost always has to be removed to clear the infection.

Facialwasting.org is a terrific web site and it must be visited for anyone interested in facial wasting. However, it would be an overstatement to suggest that one will get all the information needed to make informed decisions. Some of the content is out of date and some of it is simply wrong. That said, it is a very helpful site. Wondering what's for Dinner Tonight? Get new twists on family favorites at AOL Food.

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From: PoWeRTX@...

[mailto:PoWeRTX@...]

Sent: Wednesday, June 10, 2009 8:46 AM

Al@...

Subject: Re: Bio-alcamid

share

this with the Poz health list

In a message dated 6/10/2009 10:12:00 A.M. Central Daylight Time,

Al@... writes:

You

pose a difficult issue. The guy I know who has had most experience with BA

and its complications is Casavantes. I think a letter and telephone

consult with him would be worth it for you in determining a course of action to

take.

First

off, I am glad to hear that the IM injection is not causing issues, since I

know of no way to remove it effectively from inside muscle tissue.

What I

do know is that subcutaneous Implants have been able to be removed for the most

part. This is done with the either surgical removal or some sort of suction

with a needle or a canula. I doubt that such a large mass could be removed by

the “poke and squeeze†method that Protopapa devised. Perhaps you could

search for a very experienced liposuction doctor in NYC or a plastic and

reconstructive surgeon. I suspect that this problem will be covered by

insurance, especially since it is causing you pain. But I do have to caution

you that since Bio-Alcamid has not been used widely in the States, there are

few doctors who can or are even willing to attempt to treat problems with it.

You will have to make many calls to find someone who would be open to doing it.

If you

are unsuccessful in New York, Dr; Casavantes works with a plastic surgeon in

his building who has a great track record removing B-A completely from the face

with a liposuction canula. I would suspect that he could do the same for your

implant. The benefits of the guy in Mexico is his 2 years experience in BA

removal from faces and the cost is virtually nothing compared to what is

charged in the states. And don’t be concerned about personal security issues,

the office is in the wealthy part of town and is insulated from any of the

problems one reads about in the papers and is only 5 minutes from the San Diego

border.

Casavantes’ e mail is drcasavantes@....

Feel

free to write him or call me if you have further questions.

All the

best

al

al@...

Subject: Bio-alcamid

Al,

Several years ago I had almost a liter of bio-alcamid injected into my buttocks

by Dr. Protopapa in Brindisi.

I have no infections, but I have definitely had migration, and my butt

doesn't look so good. Mostly I am aware of a mass that has migrated to

the area between my testicles and anus.

In addition, apparently on one side the material was injected into the

gluteal muscle, whereas on the other side, on top of the gluteal muscle. There

were doctors being trained by Dr. Protopapa who injected some of the material.

Although injection into the muscle was not the preferred method, I now believe

that that method has been less disfiguring than the other.

Again no infections, but I clearly have pain in my right hip, knee and

foot, and sciatica, much of which I have attributed to arthritis.

I was wondering if you had any suggestions as to what kind of doctor (or the

name of one) that I should contact to see if some of the migrated materiel can

be removed and if some of the disfiguring bumps can be drained. I live in

NYC.

Thank you for your time in responding to me.

avast! Antivirus: Outbound message clean.

Virus Database (VPS): 090609-0, 06/09/2009Tested on: 6/10/2009 8:59:01 AMavast! - copyright © 1988-2009 ALWIL Software.

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"Several years ago I had almost a liter of bio-alcamid injected into my buttocks by Dr. Protopapa in Brindisi.I have no infections, but I have definitely had migration, and my butt doesn't look so good. Mostly I am aware of a mass that has migrated to the area between my testicles and anus. In addition, apparently on one side the material was injected into the gluteal muscle, whereas on the other side, on top of the gluteal muscle. There were doctors being trained by Dr. Protopapa who injected some of the material. Although injection into the muscle was not the preferred method, I now believe that that method has been less disfiguring than the other.Again no infections, but I clearly have pain in my right hip, knee and foot, and sciatica, much of which I have attributed to arthritis.I was wondering if you had any suggestions as to what kind of doctor (or the name of one) that I should contact to see if some of the migrated materiel can be removed and if some of the disfiguring bumps can be drained. I live in NYC.Thank you for your time in responding to me.If the material is migrating, and causing cosmetic problems, I would see a plastic surgeon for evaluation.Injecting such a large amount of liquid into the body is a bad idea, and migration is virtually guaranteed. I have seen BA migrate from the buttocks into the scrotum, thighs, and even the back of the knees. There is no natural physical barrier in that part of the anatomy to preclude the simple act of a thick fluid pouring down hill, and any competent, thinking MD should know better.Injecting BA into the gluteal muscle is an even worse idea. The needle, more a trochar, that must be used to inject 20 weight motor oil into the body is cutting and slicing muscle fibers as it goes, converting glutes into hamburger helper. I am aware of this being done in France, and although malpractice is hard to prove there, at some point, there will be a homicide conviction.JB

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