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I am here to warn everyone against Dr Daniel Cassuto and his so called laser techniques for filler induced complications. This is a personal experience meeting him and my friend undergoing treatment.
Firstly this man is an extremely rude arrogant, absolutely horrid evil man!
What he claims to be a safe way of removing permanent fillers and granulomas secondary to all permanent fillers is a complete lie.
He treated my friend who travelled to Milan from London 4 times to see him for the removal of granulomas secondary to Dermalive injections performed by Dr Yasemin Fatih Amato in Izmir, Turkey 8 years prior (Another doctor to avoid at all costs because she actually lied about what she was injecting telling us it was juvaderm which is hyaluronic acid that can last from 6 months to 2 years as it naturally dissolves out of the body. However she used Dermalive which is permanent and contains acrylic particles)

Daniel Cassuto claims that the laser melts the PMMA and is then evacuated out (laser assisted evacuation)
The procedure was absolutely agonising as he inserted large hot laser needles into the granulomas on her face. Apart from these needles leaving large pot holes in the skin, it also killed the skin tissue encapsulated around the foreign body acrylic particles. Which meant that her face got more and more infected.
She was told to take a 10 week course of very strong antibiotics before she went to see him and then another course when she came back as her face was so badly swollen and irritated again causing more health problems. (He gave no after care what so ever, no pain killers, no creams. In fact he didn\'t even respond to emails or phone calls)
The evacuation of the PMMA was done by Daniel Cassuto manually squeezing the area so harshly after the tissue damage was done with the laser, causing bruising and burst blood vessels.
She then had to go home and squeeze her own face for a week. He claims that it is infected gel, acrylic and pus that is squeezed out but really all it was, was the clear body fluid coming out.
Eventually she had to have an emergency operation in the UK to cut her face open to remove the dead tissue that was eating away at her beautiful face. If this was left any longer her face would have rotted away because of the laser burning and killing the skin tissues.
I believe this man is dangerous and purely after your money.
I wished there was a less drastic way to remove these permanent fillers from out of the face or body apart from surgical excision but really right now there isn\'t.
The most important thing for anyone out there that have these types of fillers is to avoid infections. If you have it in your face then getting your teeth and gums checked regularly is important because this is how the infection can spread to the face. Our bodies have a natural defense system that protects us from infection which is how the granulomas are formed. ( The skin is rejecting the foreign body) Like an infected spot that needs to come out.
The first sign of a little granuloma anywhere on your face or body, you must seek help to get them removed before they get bigger and bigger causing deformities....
My friend, God bless her, has only just had the surgical excision operation done so only time will tell how the scars on her face will heal and she still needs to under go another operation to get the remaining granulomas out....

Peace and love to all - God Bless

I\'ve taken this excerpt from one of the reports about migration:
Migration Studies and Histology of Injectable Microspheres of Different Sizes in Mice Gottfried Lemperle, M.D., Ph.D., Vera B. Morhenn, M.D., Vasumati Pestonjamasp, Ph.D., and Richard L. Gallo, M.D., Ph.D. San Diego, Calif.
Injectable dermal filler materials consist of either fluids, biological fragments, or suspensions of particles or microspheres. Particles and microspheres are said to 'migrate,' but migration can occur only when they are injected into blood vessels. To evaluate biocompatibility and transport, five nonresorbable polymethylmethacrylate microspheres of various sizes, suspended in different carriers, as well as resorbable polylactic acid and dextran microspheres were injected subcutaneously into mice. The five implantation sites were the right cheek, right axilla, right groin, urethra, and the right quadriceps muscle of the thigh. These sites were excised along with the local lymph nodes, lungs, liver, and spleen at 1, 3, 6, and 9 months after injection. Polymethylmethacrylate microspheres of 4 m and 8 m were phagocytosed but not transported to lymph nodes or distant organs. Larger microspheres of 20, 40, and 100 m were encapsulated by connective tissue, macrophages, and giant cells. Polylactic acid microspheres caused a mild inflammatory response and had disappeared at 6 months. Dextran microspheres caused a pronounced foreign-body reaction and were phagocytosed at 9 months. The extremely large carboncoated spheres of 200 to 500 m in diameter 'migrated' up to 1 cmfrom the implantation site. With the exception of an erroneous intravenous injection, no migration or transportation of any of the injected microspheres to lymph nodes or filter organs was seen. Obviously, the collagen glue released no microspheres. After subdermal injection, the collagen carrier substance kept the microspheres apart as a scaffold for tissue ingrowth, whereas all other carrier substances, such as gelatin, hyaluronic acid, or alginate, separated soon after injection, thereby causing agglomeration of the microspheres. (Plast. Reconstr. Surg. 113: 1380, 2004.)

Dd71 I have tried a temporary filler, It was macrolane which is basically a form of Hyaluronic acid. The result was not good, I don\'t think you would like it.

Fellas, the above excerpt, courtesy of smartman, is key. Among other things, it actually means (correct me if I am wrong) superior aesthetic results.

Yes this is true mikehok , check the 1st site I posted above .
This is a copy-paste from it :-
The bovine collagen [1, 2] appears to maintain the separation between the micro- spheres and facilitates tissue ingrowth (Fig. 2). Without ArteFill's collagen component the microspheres would clump together'a phenomenon observed in other filler formulations using hyaluronic acid-based or methylcellu- lose carriers [9].

Another one:
1. Necrosis cannot occur with cannulas since it is impossible to inject it into in artery (which has occurred with PMMAin Brazil several times in the facial artery with nasal necrosis).
2. However, foreign body granulomas can occur after PMMA, especially when injected superficially into the dermis. This is not the case with cannulas ! Granulmas after all injectables occur in about 1:1000 in the face. In buttocks and penis I haven\'t heard or read about one case. As deeper from the skin injectables are deposited, as less they cause granulomas.
3. If inflammation or granulomas should occur, thet treatment of choice are Cortisone (Kenalog) injections : 2 -5 and they should be gone within 3 - 6 months.
4. Keloids raise from the dermis and have nothing to do with a foreign body reaction around PMMA microspheres, e.g if the PMMA or injectable is injected sub-dermally as in a penis. There is no proof or relation published within the last 20 years,
5. This is the best question : The cannula runs normally between the 2 fascia , that\'s where the skin moves over the corpora (and where also an implant is inserted. The early morning erections, however, let the corpora move forwards - and with this movement, the injected PMMA or whatever becomes automatically attached to the Dartos fascia, e.g. the skin.
6. I have tested NewPlastic - and it is almost pure , e.g. free of small PMMA microspheres, which might cause inflammation. The FDA approved ArteFill is absolutely pure and causes no granulomas anymore, however , it will be 10 or 20 times more expensive : 0.8 ml cost $ 450 to the doctor ! And you will need 10 -20 ml! -
7. Since the PMMA is attached to the skin , its removal is rather difficult ! The excision can lead to necrosis and skin defects and should be avoided ! Irregularities are in my eyes the only complication you may fear - and that is something you have to discuss with Dr. Casvantes : how often has he seen it - and how did he treat it ? Probably with more PMMA into the depressions. From all injectables today, PMMA is the safest (I say this not because I am biased) . There is Macrolane from Sweden on the European and Japanese and Korean market since 2010 , a high viscous hyaluronic acid like Restylane - however, it last for 1-1,5 years only - and is much more expensive than NewPlastic.
As far as I remember he mentioned before to me :
Low concentration of PMMA ----> less irregularitiesMore concentration of PMMA ----> more irregularities