Dr Tom Decates MD

The role of biofilm, immune response and immunogenetics in soft tissue filler complications

Saturday 19th November, 14:25



The treatment algorithm in late-onset inflammatory adverse events on soft tissue fillers depends primarily on the assumed causative factor, being either immunological or bacterial. 


29 patients, of whom 13 experienced adverse events and 16 who did not. We acquired biopsies from both groups. We used a new and very sensitive method to detect microbiota, the IS-pro method.


A high level of Gram-positive bacteria was found. This suggests that these bacteria were introduced during the primary filler injection treatment.


Bacteria adherent to soft tissue fillers probably play a causative role in adverse events.

Dr Tom Decates received his medical degree at the Academic Medical Center, affiliated with the University of Amsterdam, before pursuing plastic surgery and specialising in aesthetic medicine in 2010. Since 2016 he has been conducting research into the complications of fillers at the Amsterdam UMC and the ErasmusMC in Rotterdam. In 2021 he received his PhD on the thesis: ‘The Origin of Soft Tissue Filler Adverse Events’. He is the head of the SOCG (Cosmetic Medicine Training Foundation), the training institute affiliated with the Dutch Association of Cosmetic Medicine (NVCG).