Improvement in nasolabial folds with a hyaluronic acid filler using a cohesive polydensified matrix technology: results from an 18-month open-label extension trial. [2010.11]
Repeat treatments of nonpermanent dermal fillers are used in the long-term treatment of wrinkles and folds and to volumize. OBJECTIVE To determine the safety and effectiveness of a nonanimal-sourced hyaluronic acid (HA) (which uses a cohesive polydensified matrix (CPM) technology [CPMHA]) for the treatment of nasolabial folds (NLFs) during an 18-month open-label extension trial.
A retrospective study on liquid injectable silicone for lip augmentation: long-term results and patient satisfaction. [2010.10]
Various injectable fillers are used for soft-tissue augmentation, including liquid injectable silicone [LS]...
Hyaluronic acid filler and botulinum Neurotoxin delivered simultaneously in the same syringe for effective and convenient combination aesthetic rejuvenation therapy. [2010.09]
Facial aesthetics and rejuvenation techniques have been evolving, with the most commonly applied techniques being the use of hyaluronic acid fillers and botulinum neurotoxins. Because of complementary actions, it is common for both products to be used in the same anatomical sites to optimize outcomes, either administered consecutively at one visit or at two separate visits...
[Dermal fillers: types, indications, and complications]. [2010.06]
There are many types of dermal fillers currently used for cosmetic and medical indications in routine clinical practice.Finally, we describe the most common complications encountered and their treatment.
Making the right choices: attaining predictable aesthetic results with dermal fillers. [2010.05]
The types and number of dermal fillers have evolved, allowing clinicians to select the most appropriate agent for each specific use. Filler properties differ both between and among classes, so clinicians must have a thorough understanding of these properties and the best techniques to use to provide the most satisfactory outcomes.
A double-blind, clinical evaluation of facial augmentation treatments: a comparison of PRI 1, PRI 2, Zyplast and Perlane. [2009.12]
BACKGROUND: Facial wrinkles are caused by weakening of the sub-dermal collagen support layer. Dermal fillers can be used to treat wrinkles, and this double-blind, randomised, single-centre study compared four fillers: PRI 1, PRI 2 (both porcine collagen), Zyplast (purified bovine collagen) and Perlane (cross-linked hyaluronic acid gel)... CONCLUSIONS: Results showed that PRI 1 and PRI 2 were comparable to Perlane and Zyplast as dermal fillers. Further rigorous studies are required to establish the performance of dermal fillers and patient acceptability. We propose the utilisation of stereophotogrammetry for assessment of volume changes.
Delayed inflammatory reaction to bio-alcamid polyacrylamide gel used for soft-tissue augmentation. [2009.11]
CONCLUSIONS: Despite claims of safety, Bio-Alcamid and possibly other soft-tissue fillers available worldwide have the potential to cause adverse reactions. Physicians should be aware of the various presentations and treatment options for these reactions.
Six-year experience using 1,000-centistoke silicone oil in 916 patients for soft-tissue augmentation in a private practice setting. [2009.10]
CONCLUSION: Over the 6-year period, PDMS-1000 was found to be effective and safe in the cosmetic practice setting. Other (nonpermanent) fillers were also used without incident.
Host tissue interaction, fate, and risks of degradable and nondegradable gel fillers. [2009.10]
CONCLUSION: Complications following homogenous hydrogels are caused by infection with bacteria, which have been inserted into the gel during injection. If not treated with relevant antibiotics (but instead steroids or large doses of NSAIDs) the bacteria form a biofilm, which gives rise to a low-grade chronic infection that is resistant to antibiotics. Complications following particulated gels and silicone oil are not known, but bacteria in a biofilm and/or endotoxins released by these is a possibility which deserves further investigations, primarily by using the fluorescence in situ hybridization (FISH) technique.
Dermal fillers and combinations of fillers for facial rejuvenation. [2009.10]
Until recently, the use of dermal fillers was limited in the United States by the small number of products approved by the Food and Drug Administration. The products now approved for use in the United States have opened up the range of possibilities for combinations of products that are synergistic in their effects...
Safety and effectiveness of hyaluronic acid fillers in skin of color. [2009.09]
OBJECTIVES: To assess the safety and effectiveness of hyaluronic acid (HA) fillers in skin of color... CONCLUSIONS: All of the HA fillers were well tolerated in individuals with skin of color and demonstrated effectiveness throughout the 24 week period. Furthermore, the fillers provided smooth, natural-looking wrinkle correction in darker skin types.
Lip augmentation with a new filler (agarose gel): a 3-year follow-up study. [2009.08]
BACKGROUND: Many fillers have been used to augment lips. Agarose gel is a new and absorbable filler indicated for the correction of soft tissues and lip. OBJECTIVE: This article reviews the results of 68 cases that have undergone lip augmentation with this new filler in the last 3 years... CONCLUSION: During 3 years of clinical use, agarose gel proved to be a reliable and predictable treatment for lip augmentation.
Sculptra: a stimulatory filler. [2009.05]
Sculptra is a biocompatible, resorbable injectable filler composed of poly-L-lactic acid (PLLA). It falls in the class of a stimulatory filler that creates its effect through encouraging neocollagenesis when injected... Both the natural method of volume restoration and the persistence of results of up to 2 to 3 years make this product one worthy of inclusion in the first line of tools for cosmetic rejuvenation as well as for reconstructive soft tissue deficits and lipoatrophy.
Repair of acne scars with Dermicol-P35. [2009.05]
Acne vulgaris is a prevalent skin condition that can cause disfiguring residual scarring... This article presents the aesthetic results of a male patient treated with Dermicol-P35 for severe facial acne scars.
Injectable calcium hydroxylapatite microspheres (Radiesse). [2009.05]
Injectable calcium hydroxylapatite (Radiesse) received FDA approval in 2006 for the correction of facial lipoatrophy and moderate to severe facial wrinkles.
Hyaluronic acid fillers: a comprehensive review. [2009.05]
Over the past decade, the popularity of nonsurgical cosmetic procedures has increased exponentially. Last year, according to the American Society of Aesthetic Plastic Surgery, more than 5 million procedures were performed using cosmetic injectables such as botulinum toxin and dermal filling agents.
Assessment of a new hyaluronic acid filler. double-blind, randomized, comparative study between Puragen and Captique in the treatment of nasolabial folds. [2009.05]
Fillers represent a field of aesthetic medicine under remarkable expansion. Over the past few years, in the USA, there has been a huge increase in the use of fillers, especially for hyaluronic acid (400% in 2004)... From the results obtained in this study, Puragen remained stably in the treated tissues even after 6 months while less satisfactory results were obtained with Captique.
The science and art of dermal fillers for soft-tissue augmentation. [2009.04]
Our expanding understanding of the physiological and immunological conditions of the skin and, in particular, the aging face, has prompted a growing field of aesthetic technology. Restorative procedures are taking advantage of improved and refined biotechnology, which continues to evolve at a rapid pace...
Decrease of reported adverse events to injectable polylactic acid after recommending an increased dilution: 8-year results from the Injectable Filler Safety study. [2009.03]
BACKGROUND: Injectable fillers are widely used in aesthetic medicine. Polylactic acid (PLA) is a semipermanent filler that needs to be diluted with sterile water before injection. PLA has been associated with an increased risk of adverse reactions, specifically nodule formation. OBJECTIVE: To describe adverse reactions to PLA and potential risk factors based on a partly population-based registry over an 8-year period... CONCLUSION: PLA is an injectable filler substance that may cause subcutaneous nodules in treated patients. Our data support a decreased risk of adverse reactions with an increased dilution. However, nodule formation still appears to be a characteristic feature of PLA.
Review of the efficacy, durability, and safety data of two nonanimal stabilized hyaluronic acid fillers from a prospective, randomized, comparative, multicenter study. [2009.02]
CONCLUSION: Although both NASHA fillers demonstrated similar efficacy, durability, and safety, the fanning injection technique, and a faster rate of injection played a key role in the increase in incidence of adverse experiences. Furthermore, the safety of each NASHA product was demonstrated at volumes well beyond the volume range listed on the product inserts.
Delayed immune-mediated adverse effects related to polyacrylamide dermal fillers: clinical findings, management, and follow-up. [2009.02]
BACKGROUND: It has been thought that polyacrylamide (PA) injections do not have inflammatory side effects. Recent evidence shows that local and regional delayed adverse effects may appear with its use. OBJECTIVE: To evaluate the clinical complaints and follow-up of patients with delayed immune-mediated adverse effects related to PA injections... CONCLUSION: Although it happens infrequently, local and regional delayed and recurrent granulomatous reactions may complicate PA gel injections.
A double-blind, comparative study of nonanimal-stabilized hyaluronic acid versus human collagen for tissue augmentation of the dorsal hands. [2008.08]
BACKGROUND AND OBJECTIVE: Cosmetic surgery to counteract the aging process is an evolving field. Most procedures have concentrated on the face; however, the hands are an often-neglected area. Current methods of hand rejuvenation include autologous fat injection, sclerotherapy, intense pulsed light, chemical peel, and microdermabrasion. Only autologous fat injection restores dermal thinning. We compare the use of hyaluronic acid (Restylane, Medicis Aesthetics Inc.) versus collagen (Cosmoplast, INAMED Aesthetics) for soft tissue augmentation of the dorsal hands... CONCLUSION: Aging of the hands is a common problem that is often overlooked. The use of soft tissue fillers is a viable tool in hand rejuvenation. In this study hyaluronic acid proved to be superior in efficacy to collagen.
Understanding, avoiding, and managing dermal filler complications. [2008.06]
BACKGROUND Dermal fillers are increasingly being utilized for multiple cosmetic dermatology indications... Familiarity with each family of soft-tissue augmentation products, potential complications, and their management will optimize the use of these agents.
Randomized, evaluator-blind, split-face comparison study of single cross-linked versus double cross-linked hyaluronic acid in the treatment of glabellar lines. [2008.06]
BACKGROUND At present, various hyaluronic acids are being used to rejuvenate facial skin... DCHA provides a more durable esthetic improvement when compared to SCHA in the treatment of glabellar lines.
Persistence and improvement of nasolabial fold correction with nonanimal-stabilized hyaluronic acid 100,000 gel particles/mL filler on two retreatment schedules: results up to 18 months on two retreatment schedules. [2008.06]
BACKGROUND: Nonanimal-stabilized hyaluronic acid (NASHA) fillers are frequently used for facial soft tissue augmentation. Their long-term efficacy and the effects of different retreatment schedules are not well established. OBJECTIVE: This is an 18-month interim analysis of a 30-month study to evaluate the efficacy and persistence of NASHA 100,000 gel particles/mL filler with two different retreatment schedules... CONCLUSION: The improvements seen after initial treatment with NASHA 100,000 gel particles/mL filler persisted for up to 18 months with one retreatment. The response was equivalent for retreatment at 4.5 and 9 months.
Effect of injection techniques on the rate of local adverse events in patients implanted with nonanimal hyaluronic acid gel dermal fillers. [2008.06]
CONCLUSIONS: Local adverse events following injection with the NASHA gel fillers used in this study were related to investigator technique and not to differences in the intrinsic properties of the NASHA agents.
Anatomic location of hyaluronic acid filler material injected into nasolabial fold: a histologic study. [2008.06]
BACKGROUND Products instilled within or beneath the skin to improve its physical features are known as fillers. The position of the filler within the skin is one determinant of the end cosmetic result...
A comparison of commercially available polymethylmethacrylate-based soft tissue fillers. [2008.06]
BACKGROUND The rapid market expansion of filler treatment options requires physicians and health care providers to fully understand differences among comparable products. OBJECTIVE The objective was to compare commercially available polymethylmethacrylate (PMMA)-based soft tissue fillers to determine if there are meaningful variations in these products that could result in significantly different therapeutic profiles, especially with respect to safety...
Complications after polymethylmethacrylate injections: report of 32 cases. [2008.05]
BACKGROUND: During the past 15 years, polymethylmethacrylate has been used as a synthetic permanent filler for soft-tissue augmentation... CONCLUSIONS: Polymethylmethacrylate filler complications, despite being rare, are often permanent and difficult or even impossible to treat. Safety guidelines should be observed when considering use of polymethylmethacrylate for augmentation.
Advances in facial rejuvenation: botulinum toxin type a, hyaluronic acid dermal fillers, and combination therapies--consensus recommendations. [2008.05]
BACKGROUND: Facial aesthetics and rejuvenation are evolving rapidly due to changes in products, procedures, and patient demographics. Clinicians can benefit from ongoing guidance on products, tailoring treatments to individual patients, treating multiple facial areas, and using combinations of products and ways to optimize outcomes... CONCLUSIONS: Optimal outcomes in facial aesthetics require in-depth knowledge of facial aging and anatomy, an appreciation that rejuvenation is a three-dimensional process involving muscle control, volume restoration, and recontouring, and thorough knowledge of properties and techniques specific to each product in the armamentarium.
The science of hyaluronic acid dermal fillers. [2008.03]
CONCLUSION: Knowledge of the chemical and physical blueprint of HA dermal fillers may help physicians in choosing the appropriate HA dermal filler for facial enhancements. This, together with appropriate injector training and injection experience, should lead to results that ultimately will benefit patients.
Risk profiles of different injectable fillers: results from the Injectable Filler Safety Study (IFS Study). [2008.03]
BACKGROUND: Injectable fillers are widely used in aesthetic medicine. Although most materials are considered to be safe, adverse events occur. Our knowledge on frequency and potential risk factors is limited. OBJECTIVE: The aim of this study was to describe adverse reactions to injectable fillers based on a partly population-based case series... CONCLUSION: Adverse reactions can be documented for all injectable fillers. Time until reaction as well as type of reaction, however, vary between different fillers. Further research is necessary to evaluate potential risk factors.
Patient-preferred sites of restylane injection in periocular and facial soft-tissue augmentation. [2008.03]
PURPOSE: To determine patient-preferred injection sites and frequency for facial volume augmentation with nonanimal stabilized hyaluronic acid (Restylane)... CONCLUSIONS: Patients elect to undergo Restylane injections to improve the appearance of rhytids and augment volume along infraorbital rims, malar hollows, lips, and depressed scars. Complications are minimal and easily treated.
Non-hyaluronic acid fillers. [2008.03]
Fillers are numerous, and the products currently available have effects that may last from a few months to many years. These are used to treat facial wrinkles, and some of the new fillers exert a stimulatory effect, restoring volume in focal areas of the face by inducing collagen fibers... Also, permanent fillers are traditionally linked to a higher incidence of granulomas and extrusions, although with the new formulations, the adverse events are decreased.
Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature. [2008.02]
INTRODUCTION: Implantation of dermal filler for cosmetic purposes is becoming increasingly common worldwide. It is thought that hyaluronic acid (HA) alone or combined with acrylic hydrogels (HA-AH) does not have severe nor persistent side-effects. However, recent evidence may show that major, local and/or systemic, immediate or delayed adverse effects may appear in relation with its use. OBJECTIVE: To evaluate the clinical complaints, laboratory data, treatment and follow-up of patients with delayed adverse effects related to HA and HA-AH implant fillers... CONCLUSION: Although in some cases, these clinical complications might have been associated with previous fillers or with other unknown foreign bodies, we feel that, although infrequently, delayed and recurrent chronic inflammatory and granulomatous reactions may complicate HA and HA-AH implant fillers.
Effectiveness of Juvederm Ultra Plus dermal filler in the treatment of severe nasolabial folds. [2008.01]
BACKGROUND: With the baby boomer generation firmly ensconced in middle age and the ubiquity of botulinum toxin type A, nonsurgical facial rejuvenation is becoming increasingly prevalent. As this generation continues to age, products with greater therapeutic power to correct aging changes will be in growing demand... CONCLUSION: Juvederm Ultra Plus provides correction of severe nasolabial folds through 1 year or more.
A randomized, evaluator-blinded comparison of efficacy of hyaluronic acid gel and avian-sourced hylan B plus gel for correction of nasolabial folds. [2007.08]
BACKGROUND: Five hyaluronic acid (HA)-based, biodegradable dermal fillers are approved by the U.S. Food and Drug Administration for the correction of moderate to severe facial wrinkles and folds. Because satisfactory initial correction can be obtained with all these agents, duration of cosmetic correction is an important distinguishing characteristic. OBJECTIVE: The objective was to compare the efficacy and duration of treatment effects of HA gel and hylan B plus gel for the cosmetic correction of nasolabial folds... CONCLUSION: Both HA gel and hylan B plus gel provide dermal augmentation of nasolabial folds. The magnitude and duration of nasolabial fold correction appear to be greater for the HA gel than for the hylan B plus gel.
A novel method to inject hyaluronic acid: the Fern Pattern Technique. [2007.08]
Nonanimal Stabilized Hyaluronic Acid (NASHA) has proven itself as one of the safest, most versatile dermal fillers with a high patient and physician satisfaction.The Fern Pattern Technique also uses less material to provide a correction that is not visible at rest or during dynamic movement for lines that deepen during a smile, as well as the dynamic lower nasolabial fold.
Management of visible granulomas following periorbital injection of poly-L-lactic Acid. [2007.07]
PURPOSE: Injectable poly-L-lactic acid (PLA) is a recently FDA-approved soft-tissue filler. Although approved only for treatment of HIV-associated lipoatrophy, there has been increased interest in its use for cosmetic purposes. Here we describe a case of a granulomatous reaction to injectable PLA in the inferior periorbital region resulting in visible papules and discuss treatment options... CONCLUSIONS: Given the high frequency of subcutaneous nodule formation reported in early trials of injectable PLA, it is important for physicians to be well informed regarding its potential side-effects and how to minimize risk of adverse reactions. Based on our experience, we suggest that surgical excision is an excellent treatment option for persistent papules and nodules that arise after injection of PLA in the periorbital area.
A two-stage phase I trial of Evolence30 collagen for soft-tissue contour correction. [2007.07]
BACKGROUND: The ideal dermal filler should be nonpermanent but with a durable effect lasting between 1 and 2 years, which is not the case with the resorbable fillers that are currently available. Evolence30 is a new, porcine-derived collagen gel based on the Glymatrix cross-linking technology, which results in a more natural and longer-lasting collagen product... CONCLUSIONS: Evolence30 is a new, porcine-derived collagen product based on the Glymatrix cross-linking technology that enables a safe and effective correction of the nasolabial folds. This correction lasts significantly longer than that with Zyplast.
Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, Phase III clinical trial. [2007.03]
BACKGROUND: Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. OBJECTIVE: The purpose of this study was to determine efficacy and side effects of autologous living fibroblast injections versus placebo in a randomized Phase III trial for the treatment of various facial contour defects... CONCLUSIONS: Our results indicate that autologous fibroblast injections can safely and effectively produce improvements in rhytids, acne scars, and other dermal defects continuing for at least 12 months after injection.
Adverse effects when injecting facial fillers. [2007.03]
Facial soft-tissue augmentation has become ubiquitous in cosmetic dermatology. In the appropriate patient and with appropriate training, fillers can temporarily eliminate rhytides, creases, and defects, thereby producing a rejuvenated appearance.When a complication occurs, the practitioner should understand how to manage them from observation to surgical intervention.
Technique for calcium hydroxylapatite injection for correction of nasolabial fold depressions. [2007.02]
BACKGROUND: Injectable calcium hydroxylapatite is a soft-tissue augmentation material that is used off-label for facial augmentation, including repletion of depressed nasolabial folds. OBJECTIVE: We sought to assess the safety of calcium hydroxylapatite injection for correction of nasolabial fold depressions. Specifically, we sought to obtain a quantitative assessment of injection-related adverse events using a reproducible placement technique with long-term follow-up... CONCLUSIONS: When a consistent, defined injection technique is used, injectable calcium hydroxylapatite appears to be a well-tolerated soft-tissue augmentation material for correction of nasolabial fold depressions. A long duration of effect may make this material particularly desirable for some patients.
Injectable soft-tissue fillers: clinical overview. [2006.09.15]
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Know the composition and biology of injectable fillers. 2. Understand the advantages and disadvantages of each injectable filler. 3. Understand the U.S. Food and Drug Administration regulatory status of each type of injectable filler, including their indications. BACKGROUND: The use of injectable filling agents for soft-tissue facial defects has a long history of successful use based on xenogeneic collagen materials. New materials of differing compositions for injection treatments either are now available or will soon be available for clinical use... CONCLUSIONS: As there is no single injectable filler that has all of the desired characteristics, understanding the advantages and disadvantages of one filler over another is extremely helpful in guiding the patient to an informed decision. Although all of the reviewed injectable fillers are safe, the concepts of their long-term volume persistence and how they compare with each other remain largely anecdotal, with few prospective controlled clinical trials.
Soft-tissue augmentation and the role of poly-L-lactic acid. [2006.09]
BACKGROUND: Facial rejuvenation has traditionally centered on the correction of ptosis, lines, and wrinkles, typically achieved by surgical tightening of the skin or by injecting soft-tissue fillers. In recent years, volumetric augmentation and recontouring have been recognized as fundamentally important aspects of facial rejuvenation... CONCLUSIONS: Injectable products offer a flexible means of recontouring the face and localized regions beyond the face. The potential of some of these products is supported by a wealth of published results and clinical experience, helping the physician to identify the most appropriate treatment for their patient.
Evaluation of a calcium hydroxylapatite-based implant (Radiesse) for facial soft-tissue augmentation. [2006.09]
BACKGROUND: Soft-tissue fillers have become increasingly prominent in the practice of facial aesthetic medicine. The authors sought to evaluate the long-term clinical efficacy and safety of a calcium hydroxylapatite-based filler (Radiesse) for facial soft-tissue augmentation... CONCLUSIONS: The calcium hydroxylapatite-based implant is a safe, long-lasting, highly effective, and well-tolerated agent for many areas of facial soft-tissue augmentation.
Avoiding and treating dermal filler complications. [2006.09]
All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections...
ArteFill: a long-lasting injectable wrinkle filler material--summary of the U.S. Food and Drug Administration trials and a progress report on 4- to 5-year outcomes. [2006.09]
ArteFill, the successor product to Artecoll, is an injectable wrinkle filler composed of polymethylmethacrylate microspheres and bovine collagen, which offers long-lasting and probably permanent augmentation of wrinkles and skin contour deformities... Investigator Facial Fold Assessment ratings at 4 to 5 years were improved from baseline by 1.67 points (p < 0.001).
Injectable hyaluronic acid implant for malar and mental enhancement. [2006.07]
BACKGROUND: The use of a thicker injectable implant version of one of the hyaluronic acid dermal fillers (Restylane SubQ, Q-Med, Uppsala, Sweden) is described. OBJECTIVE: A group of treated patients has been studied for more than 1 year. Restylane SubQ was injected to the submuscular plane of the upper cheeks and chin to observe efficacy of augmentation and side effect profile, and further observations were made of the duration of benefit... CONCLUSIONS: Restylane SubQ is a useful injectable agent to augment and lift upper cheeks and recontour chins. Further efficacy studies seem justified.
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