SOFT TISSUE AUGMENTATION

Abstract

Facial wrinkles and scars can be corrected by injecting implants into the dermal connective tissue. Today, several substances can be used for this purpose. Injectable bovine collagen (Zyderm and Zyplast), due to the xeuogenity of the product skin testing is required, and periodic maintance injections are necessary. Human collagen (Autologen, Dermolagen), extracted during liposuction and dermis removed during surgical procedures could be sent for processing for reinjection. Gelatin matrix (Fibre!), appears to stimulate new fibroblast collagen formation, but a skin test is needed. Autologous fat as an outgrowth of liposuction, has taken the place of silicone and is competing natural and synthetic fillers. Fascia (Fascian), are effective many years, even decades, later. Hyaluronic acid and its derivatives, are easy to handle, require no skin test and last for more than one year. Recently Bioplastique, was developed for permanent augmentation. Artecoll when injected fills the defect naturally by the body's own collagen tissue and good results remain for 5 years. Autologous human fibroblasts (Isologen), cultured from patient's skin smoke out facial lines by pumping out extra collagen in areas where have been injected, Acellular dermal allograft (Alloderm), appears to overcome the problems associated with synthetic implants and results in permanent augmentation. Gore•Tex and Alloderm have been well established, but they both need a surgical procedure, the correction is permanent and therefore difficult to remove. Scars and asymmetry of the face may be complications. These materials meet most of the characteristics that constitute an ideal injectable prosthetic material.