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Soft Tissue Fillers (soft + tissue_filler)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Complications from Injectable Polyacrylamide Gel, a New Nonbiodegradable Soft Tissue Filler

DERMATOLOGIC SURGERY, Issue 12p2 2004
Snehal P. Amin
Background. Polyacrylamide gels, containing a hydrogel composed of polyacrylamide and water, are used for soft tissue augmentation and contour correction. There are no reports of significant complications after injection of this material into the face. Objective. We report an inflammatory reaction after injection of polyacrylamide gels for zygomatic facial augmentation. Methods. A retrospective chart review of single case is presented. Results. An inflammatory reaction at the sites of polyacrylamide gels injection was noted at 1 month after initial injection. Despite two ensuing courses of broad-spectrum antibiotics, the patient presented to us with persistent draining nodules. Intralesional steroid injections resulted in prompt resolution and no recurrence. Conclusion. Inflammatory reactions have been noted in patients receiving polyacrylamide gels for breast augmentation. Facial polyacrylamide gels injections may also be associated with an inflammatory reaction that responds to intralesional steroids. With increasing availability of a variety of soft tissue fillers, dermatologists should be aware of this delayed complication from polyacrylamide gels. [source]

Hyaluronic acid filler injections with a 31-gauge insulin syringe

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2010
Adrian C Lim
ABSTRACT Hyaluronic acid gel is a commonly used skin/soft tissue filler in cosmetic dermatology. Hyaluronic acid fillers are packaged in proprietary luer-lock syringes that can be injected via a 30-gauge, 27-gauge or larger diameter needle depending on the consistency of the gel. A method of decanting proprietary hyaluronic acid fillers into multiple 31-gauge insulin syringes for injection is described. The use of a 31-gauge insulin syringe for filler injections can potentially enhance the injection process through more accurate product delivery and placement. This has the potential to produce a more balanced and symmetrical outcome for patients. Additional benefits include less injection pain, less bleeding/bruising and higher levels of patient satisfaction. [source]

Viability of Preadipocytes In Vitro: The Influence of Local Anesthetics and pH

DERMATOLOGIC SURGERY, Issue 8 2009
MAIKE KECK MD
BACKGROUND Autogenous fat transfer with lipoinjection for soft tissue augmentation is a commonly used surgical technique. Abundant donor tissue availability and relative ease of harvesting have made autologous fat an attractive soft tissue filler. The overall reliability of this technique is often disputed, and different authors describe different results after autologous fat transplantation despite using similar techniques. In this study, we examined the influence of different local anesthetics commonly used in fat harvest and the pH of the anesthetic solution on the viability of harvested preadipocytes. METHODS AND MATERIALS Preadipocytes were incubated with 1% lidocaine, 1% articaine plus epinephrine 1:200,000, 0.75% ropivacaine, and 1% prilocaine or our standardized tumescent solution (1 L of 0.9% sodium chloride solution plus 25 mL of 1% articaine plus epinephrine 1:200,000 plus 25 mL of bicarbonate) for 30 minutes. Additionally, we incubated cells with the local anesthetics as described above but diluted 1:2 with phosphate buffered saline (pH 7.4). Viability was measured using trypan blue dying as well as propidium iodine staining and fluorescence-activated cell sorting analysis. RESULTS There are significant differences in the viability of preadipocytes under the influence of various local anesthetics. DISCUSSION Our data could partially explain the varying results after autogenous fat transfer. [source]

Radiographic and Computed Tomographic Studies of Calcium Hydroxylapatite for Treatment of HIV,Associated Facial Lipoatrophy and Correction of Nasolabial Folds

DERMATOLOGIC SURGERY, Issue 2008
ALASTAIR CARRUTHERS MD
OBJECTIVES This study sought to assess the radiographic appearance produced by calcium hydroxylapatite soft tissue filler (CaHA; Radiesse, BioForm Medical Inc.) following augmentation to correct the nasolabial folds or facial wasting associated with human immunodeficiency virus lipoatrophy. METHODS A total of 58 patients, with either lipoatrophy or pronounced nasolabial folds, were treated with CaHA. Radiographic (X-ray) and computed tomographic (CT) imaging studies were conducted pre- and posttreatment in most patients; the images were sent to an independent laboratory to be analyzed by two evaluators who were board-certified radiologists and blinded to study purpose, product, and patient condition. RESULTS While results for X-ray evaluation showed inconsistencies in visualization of CaHA, CT scans showed consistent visualization in nearly all cases in patients who were imaged immediately after treatment. In addition, the results indicated no obscuration of underlying structures by CaHA and no evidence of CaHA migration. CONCLUSIONS Earlier clinical trials established CaHA as a safe and effective soft tissue filler. This CaHA study shows no overt radiographic safety concerns. CaHA is unlikely to be confused with conventional abnormal and adverse radiographic findings. The product is not always visible on X-ray. Although usually visible on CT scans, its appearance is distinct from surrounding bony structures and does not interfere with normal analysis. In addition, the product does not obscure underlying structures on CT scans. [source]

A Randomized, Bilateral, Prospective Comparison of Calcium Hydroxylapatite Microspheres versus Human-Based Collagen for the Correction of Nasolabial Folds

DERMATOLOGIC SURGERY, Issue 2007
STACY SMITH MD
BACKGROUND Current soft tissue fillers are a compromise between ease of use, duration of correction, reactivity, and cost. A product utilizing calcium hydroxylapatite (CaHA) is currently being used as a soft tissue filler. OBJECTIVE The objective was to compare the efficacy and safety of CaHA microspheres versus human-based collagen for the correction of nasolabial folds. MATERIALS AND METHODS Four centers enrolled 117 subjects with moderate to deep nasolabial folds. Subjects received CaHA on one side of the face and human collagen on the other. Up to two touch-ups were allowed. A blinded panel of experts evaluated subject photographs from initial and follow-up visits. RESULTS Seventy-nine percent of subjects had superior improvement on the CaHA side through 6 months (p<.0001). For optimal correction, significantly less volume and fewer injections were needed for CaHA than for collagen (p<.0001). Adverse event rates were comparable, with some increase in bruising and edema for CaHA-treated sides. Adverse event duration was similar for both groups and generally resolved within 14 to 21 days. CONCLUSION This CaHA-based product gives significantly longer-lasting correction of nasolabial folds compared to human collagen. Less total material and fewer injections are required. The adverse event profile of the product is similar to the collagen-based product. [source]

Use of Hyaluronidase in the Treatment of Granulomatous Hyaluronic Acid Reactions or Unwanted Hyaluronic Acid Misplacement

DERMATOLOGIC SURGERY, Issue 8 2005
Harold J. Brody MD
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. Methods. A case of persistent granulomatous reaction to injectable hyaluronic acid and a case of hyaluronic acid erroneous misplacement with their successful subsequent treatments using intracutaneous hyaluronidase are reported, along with illustrative examples of hyaluronidase use. Results. The use of hyaluronidase reduced the patient discomfort within 24 to 48 hours, deterring any patient anxiety or patient dissatisfaction. Conclusions. Hyaluronidase has a place in the treatment of allergic reactions to hyaluronidase and in the erroneous misplacement of the material. [source]

Complications from Injectable Polyacrylamide Gel, a New Nonbiodegradable Soft Tissue Filler

Hand augmentation with Radiesse® (Calcium hydroxylapatite)

DERMATOLOGIC THERAPY, Issue 6 2007
Mariano Busso
ABSTRACT:, The hand has remained a considerable treatment challenge, as new soft tissue fillers have arrived in the esthetic marketplace. The challenge has been the result of both the multiple visits required for treatment in, for example, autologous fat grafting and the simple management of pain in the innervated areas of the hand between the bones. This paper introduces a novel, noticeably less painful approach to treatment of the hand with calcium hydroxylapatite (CaHA; Radiesse®, BioForm Medical, San Mateo, CA). Anesthetic is added to the compound prior to injection, resulting in a homogenous admixture of CaHA and anesthetic. A bolus of the mixture is injected into the skin, using tenting, and then spread throughout the hand. The result of this approach , mixing anesthetic with CaHA , is treatment that is easier to massage and disseminate, less painful to the patient than conventional hand injection, and characterized by less swelling and bruising, with minimal post-treatment downtime. [source]