Injectable treatments for the aging face. [2006.05]
The use of injectable agents, specifically soft tissue fillers and botulinum toxin type A, has risen dramatically over recent years, due to the increased demand for minimally invasive techniques. In fact, today they represent the most commonly performed cosmetic procedures in the United States, with botulinum type A injections topping the list.
Hyaluronic acid gel (Restylane) filler for facial rhytids: lessons learned from American Society of Ophthalmic Plastic and Reconstructive Surgery member treatment of 286 patients. [2006.05]
PURPOSE: To review injection techniques and patient satisfaction with injection of Restylane in various facial areas by American Society of Ophthalmic Plastic and Reconstructive Surgery members... CONCLUSIONS: Injection techniques, volume, end points, and anesthesia vary for different facial areas and between practices. Patients experience mild to moderate injection discomfort that is lessened with injectable lidocaine. Self-limited problems occur in about 5% of patients. Physician-determined patient satisfaction is perceived to be higher than that of collagen injection but slightly lower than that of botulinum toxin injection. The major source of Restylane patients was from existing practice patients, especially botulinum toxin patients.
ArteFill: a permanent skin filler. [2006.05]
The ideal soft-tissue filler for wrinkles and skin defects should be safe, biocompatible, resistant to phagocytosis, persist and maintain its volume without being resorbed or degraded. ArteFill, an improved, next-generation derivative of Artecoll, is expected to become the first and only FDA-approved permanent filler for use in the USA in 2006 and will be available worldwide.
Effect of monopolar radiofrequency treatment over soft-tissue fillers in an animal model: part 2. [2006.03]
BACKGROUND AND OBJECTIVE: Monopolar radiofrequency (RF) treatment is used by physicians to heat skin and promote tissue tightening and contouring. Cosmetic fillers are used to soften deep facial lines and wrinkles. Patients who have had dermal fillers implanted may also benefit from or are candidates for monopolar RF skin tightening. This study examined the effect of RF treatment on various dermal filler substances. This is the second part of a two-part study... CONCLUSIONS: Monopolar RF treatment levels that are typically used in the clinical setting were employed in this animal study. RF treatment resulted in measurable and statistically significant histological changes associated with the various filler materials. Additional clinical and histological studies are required to determine the optimal timing of monopolar RF treatment and filler placement for maximal potential aesthetic outcome. 2006 Wiley-Liss, Inc.
Cutaneous sarcoidal granulomas developing after Artecoll facial cosmetic filler in a patient with newly diagnosed systemic sarcoidosis. [2006.03]
Artecoll is a recently developed permanent synthetic cosmetic filler substance, composed of 80% bovine collagen and 20% polymethylacrylate (PMMA) microspheres of 32-40 mum in diameter. It is used for the augmentation of deep wrinkles and is to be injected subdermally... We postulate that the PMMA foreign material contained within Artecoll acted as a stimulus for the development of the cutaneous sarcoid granulomas.
Consensus recommendations for soft-tissue augmentation with nonanimal stabilized hyaluronic acid (Restylane). [2006.03]
The American Society for Aesthetic Plastic Surgery recently reported that there were nearly 12 million cosmetic procedures (2.1 million surgical and 9.7 million nonsurgical) performed in the United States in 2004. Almost 900,000 of the nonsurgical procedures were soft-tissue augmentation procedures using hyaluronic acid fillers.
Techniques for soft tissue augmentation: an 'a to z'. [2006]
As society continues to seek the most opportune means to preserve youthful looks, an interest in filling substances has been reawakened. This is partly because the upper third of the face can now be successfully treated as a result of the development and recent US FDA approval of botulinum toxin (Botox).
Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement. [2005.08]
BACKGROUND: In the past, reactions or misplacement of soft tissue fillers has been fraught with anxiety because time has been the main thrust for improvement in spite of ancillary treatments. Hyaluronidase is an enzyme that dissolves hyaluronic acid in the skin and also assists in the management of granulomatous foreign-body reactions to hyaluronic acid. These reactions may be caused by allergy to the material or immunologic response to the protein contaminants in the hyaluronic acid preparations. Dissolution of material in erroneous placement of material and in allergic reactions can be a time saver and a deterrent to patient dissatisfaction. OBJECTIVE: To evaluate the use of hyaluronidase in the treatment of both allergic reactions and the erroneous misplacement of hyaluronic acid in the skin... CONCLUSIONS: Hyaluronidase has a place in the treatment of allergic reactions to hyaluronidase and in the erroneous misplacement of the material.
Injected hyaluronidase reduces restylane-mediated cutaneous augmentation. [2005.07]
OBJECTIVE: To determine the effects of injected hyaluronidase in cutaneous areas previously augmented with Restylane (Q-Med AB, Uppsala, Sweden), a nonanimal, stabilized hyaluronic acid (NASHA) gel... CONCLUSIONS: Intradermal hyaluronidase injections can be used to reduce dermal augmentation from previously injected Restylane. A small dose of hyaluronidase equivalent to 5 to 10 U may be injected initially.
Filling agents. [2005.06]
Injectable fillers have become an important component of minimally invasive facial rejuvenation modalities. Their ease of use, effectiveness, low morbidity, and fast results with minimal downtime are factors that have made them popular among patients...
Scar sarcoidosis after hyaluronic acid injection. [2005.05]
A 54-year-old woman presented with a 5-month history of tender nodules in both nasolabial folds that had developed 4 months after the injection of hyaluronic acid (HA) (Restylane) for wrinkles. The patient was treated with 1.5 mg/day betamethasone for 6 days and her lesions disappeared within 1 week...
The evolution of soft tissue fillers in clinical practice. [2005.04]
To remain experts in skin care and treatment, every dermatologist must be aware of the evolving role of soft tissue fillers in dermatology. Patients with facial scarring, lipodystrophy, contour abnormalities, and age- and sun-induced rhytids can be successfully treated... This discussion of the specific risks, indications, and technical pearls for the various fillers will allow clinicians to accurately advise or treat patients.
Soft tissue implants and fillers. [2005.04]
The number and variety of soft tissue implants and fillers at the clinician's disposal continues to increase rapidly as new materials and bioengineering techniques evolve. The ideal implant for all purposes does not yet exist, so the clinician must be familiar with a wide variety of products for each application.
Injectable skin fillers. [2005.04]
The list of injectable skin fillers available for soft tissue augmentation is constantly growing, giving aesthetic surgeons more options in the treatment of scars, lines, and wrinkles. Each type of filler is distinct with regard to intended use, placement technique, duration in tissue, ease of use, and cost...
Safety and efficacy of nonanimal stabilized hyaluronic acid for improvement of mouth corners. [2005.03]
CONCLUSIONS: NASHA injection to support the age-related downturn of lateral lip corners was effective, safe, and well tolerated in a small prospective study of middle-aged female subjects. Esthetic satisfaction was greatest in the first 3 months post-treatment, but 40% of subjects still noted improvement at the 6-month follow-up visit.
Managing inflammatory reaction to restylane. [2005.03]
A 62-year-old woman received injections of Restylane, cross-linked hyaluronic acid, for the cosmetic filling of facial rhytids and developed a severe dermal inflammatory reaction.
Clinical Use of RESTYLANE. [2005.02]
There is no ideal filler, nor will there be a single product that can satisfy all requirements. However, RESTYLANE, a non-animal, stabilized hyaluronic acid (NASHA, Medicis), is a very versatile augmenting agent... This review will outline the background to the use of RESTYLANE, and will focus on the clinical use of this material.
Midface volume replacement with a transmaxillary implant. [2005.01]
BACKGROUND: Volume replacement is an essential component of midface rejuvenation. Previously designed alloplastic implants augment bony prominences. The Maxout implant was configured to add height to the lowest surface, the canine fossa... CONCLUSIONS: The Maxout implant is easy to insert and remove, aesthetically effective, secured by bone structures, and located in a neutral position. The risk of infection must be considered, especially for HIV-positive patients.
A randomized, evaluator-blind, multicenter comparison of the efficacy and tolerability of Perlane versus Zyplast in the correction of nasolabial folds. [2005.01]
Bovine collagen is widely used as a dermal filler for facial soft-tissue augmentation, but it provides only temporary cosmetic improvement...
The use of poly-L-lactic acid in the management of soft-tissue augmentation: a five-year experience. [2004.12]
Poly-L-lactic acid (PLA) New-Fill* is one of the latest implants commercialized among bioresorbable fillers...
The histological aspects of fillers complications. [2004.12]
The histological aspects of resorbable heterologous fillers (bovine collagen, acid hyaluronique), autologous fillers (lipofilling, dermis-fat graft), biodegradable fillers (New-Fill), and permanent fillers (silicone, Artecoll, Evolution, Aquamid, DermaLive, DermaDeep, Bioplastique, Paraffin) are described.
Polymethyl methacrylate microspheres in collagen. [2004.12]
Artecoll was developed about 20 years ago and underwent a number of production changes until it recently became FDA approved under the new name of Artefill. This product contains 20% polymethyl methacrylate (PMMA) microspheres with a diameter of 30 to 40 microm, which are suspended in a 3.5% atelo-collagen solution...
Hyaluronic acid and its use as a "rejuvenation" agent in cosmetic dermatology. [2004.12]
Since 1996, hyaluronic acid (HA) has been launched onto the market in Europe... Most of these complications are not severe and will disappear when the product is degraded.
Biocompatibility of microparticles into soft tissue fillers. [2004.12]
The increasing need for long-lasting injectable soft tissue fillers for the treatment of wrinkles and folds requires a critical discussion of the biocompatibility on a scientific background. Since biological fillers made of collagen and hyaluronic acid will be resorbed over time, copolymer biomaterials with microparticles have been developed in recent years...
Nonanimal stabilized hyaluronic acid for lip augmentation and facial rhytid ablation. [2004.11]
OBJECTIVE: To evaluate the effectiveness of nonanimal stabilized hyaluronic acid as an injectable filling agent... CONCLUSIONS: Nonanimal stabilized hyaluronic acid is an effective and safe facial soft tissue expander. Its duration varies with each facial area treated.
Localized granulomatous reaction to a semi-permanent hyaluronic acid and acrylic hydrogel cosmetic filler. [2004.11]
Dermalive, an injectable skin filler composed of a combination of synthetic hyaluronic acid and acrylic hydrogel particles was recently developed for soft tissue augmentation. Dermalive produces longer term results than temporary injectable fillers and is associated with a reportedly low incidence of adverse reactions...
[Soft tissue filling with hyaluronic acid] [2004.10]
CONCLUSION: Although their duration of effect is limited, HA products are the most commonly used fillers, before collagens. Many questions have yet to be answered, but they produce very significant results in filling procedures. Both clinicians and patients praise these products for their tolerance, resorbable nature, and limited side effects.
[Slowly absorbable and non absorbable injectable products] [2004.10]
Products which are non absorbable or slowly absorbable make the correction of facial wasting of any origin possible.In order to avoid this the following are necessary: clinical and histological analysis of facias granulomas, a proposal for guidelines for their use which would predict in situ tolerance.
Evaluation of the safety of a non-animal stabilized hyaluronic acid (NASHA -- Q-Medical, Sweden) in European countries: a retrospective study from 1997 to 2001. [2004.07]
CONCLUSION: NASHA is a very useful and safe filler product. Skin testing does not seem to be necessary.
Erasing restylane. [2004.07]
A 65-year-old woman received injections of Restylane, cross-linked hyaluronic acid, for the intended cosmetic filling of periorbital rhytids. The achieved result was undesirable, and the filler lasted more than 5 years.
Soft tissue augmentation using sculptra. [2004.05]
Sculptra (poly-L-lactic acid) as of August 2004 has been approved by the U.S...
Soft tissue augmentation using Restylane. [2004.05]
Soft tissue augmentation plays an important role in facial rejuvenation.
Radiance. [2004.05]
New injectable agents are expanding the role of fillers in facial soft tissue augmentation. Radiance FN (fine needle) is a new injectable filler composed of calcium hydroxylapatite (CaHA) microspheres suspended in an aqueous gel carrier...
Hylaform: a new hyaluronic acid filler. [2004.05]
Hylaform is a new facial filler composed of hyaluronic acid.It works particularly well in wrinkles, grooves, and thin lips deflated from aging changes.
Cymetra. [2004.05]
Soft tissue replacement using a filler as a temporary scaffold to encourage revascularization and tissue in growth is an exciting concept. Sheets of acellular human dermal matrix, called Alloderm (Lifecell Corp, Branchburg, NJ), have been shown to do just that.This article reviews the manufacturing, tissue interaction, clinical applications, and anticipated clinical results.
CosmoDerm/CosmoPlast (human bioengineered collagen) for the aging face. [2004.05]
Type 1 collagen loss in the dermis is one of the primary causes of wrinkles seen in aged skin. Dermal fillers using type 1 collagen derived from bioengineered skin are now being used to treat facial wrinkles...
Advanta implants. [2004.05]
Advanta is a new expanded polytetrafluoroethylene implant with dual porosity that can be used to enhance facial features... The implants feel soft and natural and the complication rate is low.
A study on patients treated with polyacrylamide hydrogel injection for facial corrections. [2004.01]
Polyacrylamide hydrogel (PAAG) has been used as a tissue filler in facial corrective surgery and for breast augmentation in Kiev, Ukraine, for more than 10 years with reportedly very good results. These results, however, have not been published in peer-reviewed journals... Currently, the product (Aquamid) is being studied in several prospective clinical trials, one of which is completed and in the process of preparation for publication.
Granulomatous foreign body reaction against hyaluronic acid: report of a case after lip augmentation. [2003.12]
CONCLUSION: To our knowledge, this is the third case of granulomatous body reaction against this substance, which was allegedly inert in humans. Although rare, this reaction can have important aesthetic implications, and the patients should be informed about their risks.
A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox) and nonanimal sourced hyaluronic acid (NASHA, Restylane) in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A. [2003.08]
BACKGROUND: Over the past 15 years, BTX-A has become the standard treatment for dynamic glabellar furrowing... The median time for return to preinjection furrow status occurred at 18 weeks in the NASHA-alone group compared with 32 weeks for the BTX-A plus NASHA group.
Soft-tissue fillers for wrinkles, folds and volume augmentation. [2003.06]
Hyaluronic acid gels, with or without dextran beads, and collagen with suspended PMMA microbeads are exciting new soft-tissue fillers that are becoming increasing popular for facial rejuvenation. Each material provides wrinkle reduction, contour improvement and volume augmentation when placed into lines and furrows or when used for lip augmentation.
A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. [2003.06]
BACKGROUND: Bovine collagen is extensively used for facial soft tissue augmentation but provides only temporary correction and can cause hypersensitivity reactions. Hyaluronic acid derivatives potentially offer improved longevity of correction and a reduced risk of immunogenicity and hypersensitivity. OBJECTIVE: To compare the efficacy and safety of nonanimal stabilized hyaluronic acid gel (Restylane; Q-Med, Uppsala, Sweden) with that of bovine collagen (Zyplast) for treatment of nasolabial folds... CONCLUSION: Nonanimal stabilized hyaluronic acid provides a more durable aesthetic improvement than bovine collagen and is well tolerated.
Rejuvenation of the aging lip with an injectable acellular dermal graft (Cymetra). [2002.10]
OBJECTIVE: To evaluate the effects of Cymetra (micronized AlloDerm tissue) in rejuvenating the aging and atrophic lip. PATIENTS: Forty-four patients aged 32 to 80 years who reported age-related changes in the size and contour of the upper lip... CONCLUSIONS: Cymetra is a suspension of particulate dermal matrix that seems to increase the upper lip bulk, vermilion, and lower lip projection after a threshold of Cymetra has been administered. There are few differences in any measured long-term (3 months after treatment) variables until the 12-month visit, when there were statistically significantly more Cymetra-treated patients with improved lip aesthetics than those treated with Zyplast. With repeated treatments, Cymetra seems to accumulate, producing a long-term effect superior to Zyplast in many patients.
Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation. [2002.06]
CONCLUSION: According to the reported worldwide adverse events data, hypersensitivity to nonanimal hyaluronic acid gel is the major adverse event and is most likely secondary to impurities of bacterial fermentation. According to data from 2000, the incidence of hypersensitivity appears to be declining after the introduction of a more purified hyaluronic acid raw material.
Hyaluronic acid skin fillers: adverse reactions and skin testing. [2001.12]
BACKGROUND: Hyaluronic acid (HA) fillers have been proposed as alternatives to other temporary skin fillers, such as bovine collagen, for treating facial skin lines and for providing lip augmentation. Several types of commercial HA fillers are now available in many countries. They include Restylane, which is produced by microbiologic engineering techniques, and Hylaform, which is HA extract derived from rooster combs. They have been approved for use in several countries, but not currently in the United States. There are no recommendations to perform pretreatment skin testing by the manufacturers. OBJECTIVE: Our purpose is to describe and comment on our experiences with Hylaform and Restylane fillers. Observation of any side effects and skin testing results were documented... CONCLUSIONS: There was a slight incidence of delayed inflammatory skin reactions to two HA fillers. Both of these reactions occurred after the first and repeat injections. Challenge skin testing was positive in 4 of 5 tested patients.
Survey of future injectables. [2001.08]
There has been an explosion in the technology of injectable filler materials for soft tissue augmentation of the face in the past decade. As a result, this is an exciting field and has provided surgeons who treat the aging face with newer, minimally invasive tools and techniques to augment the soft tissues of the face...
Collagen substances. [2001.05]
Soft tissue enhancement has become increasingly important as more patients seek aesthetic improvement without major surgical procedures. Injectable Zyderm bovine collagen has come to be regarded as the "gold standard" of injectable or implantable fillers, against which all other fillers are measured.
Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study. [1998.12]
BACKGROUND: Several biomaterials are available for the purpose of soft tissue augmentation, but none of them has all the properties of the ideal filler material. The recent development of hyaluronic acid gels for dermal implantation give the physician new possibilities of effective treatment in this field. OBJECTIVE: This study provides a clinical and histological evaluation of safety and efficacy of a cross-linked stabilized non-animal hyaluronic acid gel (Restylane, Q-Med, Uppsala, Sweden) to determine its characteristics, advantages, disadvantages, and side-effects... CONCLUSIONS: Stabilized, non-animal, hyaluronic acid gel is well tolerated and effective in augmentation therapy of soft tissues of the face. This material presents several advantages in comparison to previously used injectable biomaterials and expands the arsenal of therapeutic tools in the field of soft tissue augmentation.
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