Six years ago a new filler for permanent tissue augmentation by injection was introduced in Europe, Aquamid® . The information about this material is put in front of our normal information on nose corrections, which of course still should be read by anyone seeking information about this type of operation.

As general tissue augmentation like breasts, lips, malars, chins and calf for a long time have been and still are demanded corrections, the industry has been seeking for a suitable substance for this indication. Through years injectables with time restricted durability like collagen and hyaluronic acid have been used. Due to resorbtion the injections had to be repeated. Allergic reactions have been reported.

Other injectable substances with more or less permanent durability have also been used. These are silicone and polymethylmethacrylate, which can aggregate and cause lumps or disappear depending on the molecular size. Again other materials as a permanent filler is the Gortex® tube.

Autologous tissues with a variety of long term results have been used. Fat injections do mostly have a transient filling effect and are no alternatives for permanent augmentation. Fat-dermis or fascia implants do commonly have a permanent filling effect, although they can be absorbed. Acellular implants from corps does also exist for this purpose. Biologic auto transplants need vascular ingrowth to survive and if this does not occur, the material is partially or totally absorbed.

Bigger augmentations like breasts, muscle, buttocks etc. can only be achieved by implants today. Although hyaluronic acid is tested clinically for breast augmentations. Aquamid® is a neutral hydrogel consisting of a stable chain of polyacrylamide in 90% of water.

Polyacrylamide should not be confused with the poisonous acrylamide. The gel can be directly injected into the subcutis where it integrates with the tissues. If injected gel is to be removed, it can at least partially be aspirated or pressed out during the first 8 months after injection. After this time there is an ingrowth of fibrous tissues into the gel which makes a surgical removal necessary to ablate it. Polyacrylamide gel has been used successfully for over 10 years in Ucraine, mostly for breast augmentation and facial corrections. The cosmetic results have been excellent with a very low frequency of side effects/complications of about 0,02%.

This information is related to facial corrections as the only officially cleared indication.

Method: With a very thin needle, the gel can be introduced into areas to be filled or enlarged.
Typical areas:
 Malar region, chin, cheeks, lips and nose.
There will be a short swelling and erythema that will disappear within 12 hours.
There will be no pain.
The injected gel stays soft or hard depending of the injection technique and it does not migrate.
The treatment is done under local or bloc anesthetic. The anesthesia makes the face feel hard and big, but have no fear, it is invisible! The analgesia disappears within a couple of hours.
No after treatment is needed.

Side effects:
No reports of any complications so far.
· Irregularities can occur. This can be corrected by massaging or secondary injections. It is important that the physician should be able to see and to manage these side effects.


Infections can occur when the needle penetrates the skin. Antibiotics is then prescribed.


Sometimes it is difficult to decide what volume is aesthetically needed. If one is in doubt, it is better to give a secondary treatment at a later time than to overinject.


Injected Aquamid® can be firm for a month. It softens gradually with time.

Aquamid® will be cleared for other indications. At that time more information will be completed.