Bio-Alcamid™ (Polymekon, Italy) is a relatively new, injectable soft tissue endoprosthesis that is recommended for correcting soft tissue defects and contour deformities. It consists of 96% water and 4% synthetic polymeric polyalkylimide, and once injected becomes enclosed within a thin collagen capsule.We have treated a selected series – 34 patients, 57 anatomical sites treated in 64 treatment sessions, with a range of 2.5ml to 110ml injected per site per injection. The indications have been as diverse as anti-retrovirus treatment associated facial lipoatrophy, pectus excavatum and post-breast reconstruction contour deformities. The patients were followed up in clinics and through a postal questionnaire survey.The longest follow up we have now is over eighteen months. The results have been uniformly good and satisfactory to both patients and the surgeon. The patients tolerated the treatment very well under local anaesthesia. The questionnaire survey showed universally high degrees of satisfaction. The biggest advantages of Bio-Alcamid over other filler injections have been permanency of volume correction and a very natural soft feel of the treated areas. Many patients required a single treatment only to correct significant volume defects.In our experience, Bio-Alcamid is safe and fulfils most of the criteria of an ideal injectable filler material.