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Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Fillers represent products that are inserted into different skin layers to improve angles, lines, folds, scars and flaccidity. The idea is to replace an original volume lost by the aging process or to create volume. Fillers can be temporary or permanent. Although hyaluronic acid is safe, it binds up to one thousand times its weight in water forming a viscous quality similar to ‘jelly’ that causes an overinflated look. The newer generation biodegradable polycaprolactone-based collagen stimulators restore volume and redefine contours in a more natural way. Severe but rare complications of fillers include undesired aesthetic result, skin necrosis and blindness (which is a surgical emergency). These should be mentioned in the consenting process. Generally, we recommend avoiding the use of permanent fillers, which have additional complications of long-term damage, inflammation, infection and extrusion.
The history of dermal fillers
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Formulations of non-permanent dermal filler which are not HA based include poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHa). PLLA was first licensed by the FDA in 2009 under the trade name Sculptra®. These fillers are broken down over an average of nine months to two years after administration; however, their cosmetic effects often last longer than this due to stimulation of neocollagenesis through activation of dermal fibroblasts. CaHa fillers are made up of microspheres which illicit minimal foreign body reaction, do not migrate within tissues and trigger neocollagenesis alongside their volume-enhancing effects. As it is a more viscous filler, CaHa is primarily designed for use in deeper soft tissues, such as the cheeks. See Figure 2.1.
Interactions with Medical-Aesthetic Treatments
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
Silvia Gabriela Ortiz Zamorano, Victoria Zamorano Triviño
Although there are no publications about the safety of aesthetic-medical treatments in patients receiving bisphosphonates, it seems prudent not to carry out any type of treatment that puts an implant of hyaluronic acid, calcium hydroxyapatite, or other compounds used in aesthetic medicine in contact with the bone surface in these patients (Figure 14.2). In recent years, treatments with fillers have been extended to volumize facial areas directly over the periosteum. As these often involve techniques in which contact of the needle with the periosteum can produce small bone lesions, the use of these techniques is not recommended in cancer patients who are receiving bisphosphonate. It would be prudent in these cases to use other infiltration techniques that do not involve direct contact with a bone surface that may have reduced turnover, with decreased blood supply and increased risk of bacterial aggression; the reduction of blood supply, decreased bone turnover, and bacterial aggression of oral flora are routinely cited as the main reasons for the occurrence of osteonecrosis in these patients.
Hyaluronic acid gel injection for dysthyroid upper eyelid retraction in Asian patients
Published in Orbit, 2023
Stephanie Ming Young, Jeong Hee Kim, Yoon-Duck Kim, Virongron Karnsiritanont, Stephanie S Lang, Kyung in Woo
There are a few limitations to our study. This was a retrospective study with its inherent bias. The age of the study is another limitation as it was performed from 2011 to 2013. One reason is that we wanted a longer follow-up to reaffirm our findings that filler may stay in the eyelid region for more than 10 years, although the common belief is that they are temporary and dissolve in 9–18 months depending on the type of filler used. We had a relatively small number of patients, although this is larger than other pilot studies reporting the use of HA filler in the upper lid for management of retraction. While other studies included patients with UER of different etiologies, we included only patients with TED-related UER, hence giving a more focused and representative study population. Follow-up was varied among our patients, although we did have many patients with more than 1-year follow-up. Long-term follow-up will better clarify the duration of HA effect, the frequency needed for reinjections and to detect any complications of long-term use of HAG in the eyelid.
Crosslinking hyaluronic acid soft-tissue fillers: current status and perspectives from an industrial point of view
Published in Expert Review of Medical Devices, 2021
Jimmy Faivre, Amos I. Pigweh, Julien Iehl, Pauline Maffert, Peter Goekjian, François Bourdon
The use of injectable soft-tissue fillers has become increasingly popular in esthetic medicine because it offers an opportunity for facial rejuvenation, as well as plastic and reconstructive improvements via minimally invasive procedures [1–4]. As long-term resorbable implantable gels, they are classified as class III medical devices by most Regulatory Authorities. Fillers are substances that are injected within or beneath the skin layers in order to restore lost volume, smooth lines, soften creases, or enhance facial contours. The earliest forms of fillers included permanent silicone or polymethacrylate implants (the former having been withdrawn in several countries by competent bodies), and resorbable collagen-based fillers [2,5,6]. The use of these products has raised safety concerns due to side effects such as overcorrection, inflammatory responses such as late-onset granulomatous reactions [7], and the need for prior allergy testing. This has therefore led to the search for safer soft-tissue fillers [5,8,9]. More recently, Hyaluronic Acid (HA)-based gels have become the gold standard for soft-tissue filling, thanks to their long safety records, biocompatibility, and low toxicity and immunogenicity profiles, as well as their versatility of applications in biomedicine and hydrogel design [10].
A novel autologous dermal filler based on cultured fibroblasts and plasma gel for facial wrinkles: Long term results
Published in Journal of Cosmetic and Laser Therapy, 2021
Yasemin Oram, A. Deniz Akkaya, Ethem Güneren, Gürsel Turgut
For the fibroblast cell cultures, we used patients’ own activated PRP for cell proliferation. It was previously shown that the addition of 5% activated PRP to the culture medium, maximally promoted the proliferation of human dermal fibroblasts via activation of intracellular ERK1/2 signaling (19,20). Furthermore, the plasma gel component of Fibrogel was prepared from the patients’ own plasma. Hence, Fibrogel is merely autologous, nontoxic, biocompatible, non-animal based and non-allergic. Therefore, severe complications observed with other fillers including vascular occlusion, nodule formation, hypersensitivity reactions, or migration of the filler are not expected (21). Erythema, edema, and pinpoint purpura due to needle puncture were the only local side effects after Fibrogel injection, all of which resolved in 3–4 days.