Long Lasting Results with Hydroxyapatite Facial Filler
Patricio F. Jacovella, M.D. Ph.D. ; Claudia B. Peiretti, M.D.;
Diego Cunillé, M.D.; Mauricio Salzamendi, M.D. and Sophia Asiu
Schechtel, M.D.
Injectable soft tissue filler substances play
in the aesthetic treatment of the aging face.
physicians and investigators world wide have
the ideal filling material: considerable long
biocompatibility, absence of side effects and
benefit ratio.
an important role
For many years,
been looking for
lasting,
reasonable cost-
Objective: to present the experience with synthetic calcium
hydroxyapatite soft tissue filler for aesthetic facial
corrections.
Material and methods: the study was carried out in the Plastic
Surgery Division, Hospital de Clinicas, Buenos Aires, Argentina.
Forty male and female patients were injected in 55 different
anatomical regions to improve aesthetic appearance: glabellar
wrinkles, nasolabial folds, lips, nose and infraorbital region.
Radiance TM (Bioform Inc.) is a sterile latex free, non
pyrogenic, cohesive subdermal implant, composed by synthetic 25
to 45 microns particles of calcium hydroxyapatite in sodium
carboximethilcelulose as a carrier. The average volume injected
was 0.75 cc.
Technique: a 25 G needle was introduced subdermally and the
product was injected while withdrawing.
Results: As temporary adverse effects, 5 % showed ecchymosis and
hematoma. Only one patient developed a lip nodule which had to
be removed by surgery without complications. No systemic
reactions were seen within 12 months follow up. Immediate
achieved results remained for the mentioned follow up period.
Patients' satisfaction scale showed 87 % acceptance as very good
results.
Fig.1: Glabellar line
Fig.2: After 0.5 cc
Fig.3: Nasal tip projection
Fig.4: NL folds
Fig.6: Lips pre
Fig.5: 0.5 cc/ each side
Fig.7: 1cc/ each lip
Discussion:
There is a big quantity of injectable filling materials in the
aesthetic plastic Surgery arena.1,2
Temporary filling materials like autologous fat 3 and bovine
collagen, present some disadvantages: short lasting time (3 to 6
months) for both;
previous skin testing for collagen and two
procedures ( to obtain and inject) for fat.
Only hyaluronic acid could be preferred as a good temporary
filler despite of the 6 months lasting time.2
Permanent
fillers
such
as
polymethilmetacrilate
and
dimethilpolixiloxane in particles 4,5, have been used for
augmentation purposes in non surgical facial rejuvenation. The
biggest disadvantage of the mentioned products is that they last
forever and if the desired results are not achieved, it is
difficult if not impossible to remove them.
Due to reported side effects like granulomas, migration and
systemic reactions, liquid silicone injections should not be
allowed.6
Histological studies published by Probeck 7 and Pettis 8 have
verified that the carboximetilcelulose as a carrier is completely
absorbed after 12 months and that the particles remain surrounded
by connective tissue.
Hidroxyapatite
particles
have
been
used
in
urology
for
incontinence treatment with good results.9
Most of the main
desirable properties for a filling material have been achieved
with this product. Despite a larger number of patients and a
longer follow up is necessary, it can be considered a very good
option as a soft tissue long lasting filler.
Bibliography
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tissue augmentation , Plast. Rectonstr. Surg 1984,84: 921-934.
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hydroxyapatite.
J. Oral Maxillofacial Surg. 1989, 42:143-149.
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