Episode 170 hosts Dr Tom Decates from Amsterdam, Holland.   Dr Decates is a Cosmetic Physician who also specialises in cosmetic complications. He works at the Erasmus University Hopsital where he and his colleagues offer the only filler complications centre in the world. He has undertaken formal research in the field and completed his PhD in 2021 entitled, 'The origin of soft tissue filler adverse events'.  In part one of a two part episode (out next week), we discuss:  - Dr Decates background - Insights into how the filler complications centre started and how it's funded - What is the immune system's normal response to fillers when they injected? - Is it possible for a filler to be non-immunogenic? - What do we mean by ‘filler integration’? - What happens when fillers are broken down and do the small molecular weight chains of filler create an inflammatory process? - What type of patients are not medically suitable for fillers?  - Can we treat patients with autoimmune disease? - Whether oral hygiene or a recent dentist appointment matters when considering injecting a patient with fillers? - COVID vaccines & filler reactions: What was the outcome of this and did we see more filler complications?    - How to clean a patients face before a filler treatment - Bacteria and the formation of biofilm: what is it?   - The issue with swabbing wounds and abscesses: why are they often reported as 'sterile' and where are the bacteria?   - The genetic link and HLA: why a small sub-group of the population are prone to filler reactions  - A new cheek swab that promises to identify such patients and help avoid up to 85% of immune-related complications   Show your support for IA via Patreon Follow IA on Instagram Visit our website  Subscribe to IA on Apple Podcasts Subscribe to IA on Spotify Contact Dr Jake & David  More about Dr Jake Follow Dr Jake on Instagram  Follow David on Instagram Follow Tom on Instagram