Dermal Fillers

Description

The aging process affects every aspect of the body, with the face being one of the first places to show signs. The search for the perfect injectable filler has taken an interesting path with the majority of innovations having been introduced in the last 30 years. The patient-driven demand for safe and effective minimally invasive aesthetic procedures has led to the development of an expanding and competitive market for dermal fillers. The demand for soft tissue augmentation has grown rapidly since its start in 1981 with collagen fillers. Fillers using hyaluronic acid, calcium hydroxyapatite, poly-L-lactic acid, and polymethylmethacrylate provide a wide range of options so that the best cosmetic outcome can be attained. The ability to correct facial rhytides and folds, to augment lips and cheeks, to correct acne scars, and now even to replenish volume loss in the dorsum of the hands is something that many practitioners thought would never be possible. This publication reviews the history of fillers, injection techniques, complications and safety as well as the novel use of fillers and fillers of the future.

Informations

• Publié par: S. Karger AG
• Date de parution: 21 novembre 2017
• Nombre de lectures: 1
• EAN13: 9783318061253
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Dermal Fillers
Aesthetic Dermatology
Vol. 4
Series Editor
D.J. Goldberg New York, NY
 
Dermal Fillers
Volume Editor
D.J. Goldberg New York, NY
66 figures, 62 in color, and 7 tables, 2018
_______________________ Dr. David J. Goldberg Director, Skin Laser and Surgery Specialists of New York and New Jersey New York, NY (USA)
Library of Congress Cataloging-in-Publication Data
Names: Goldberg, David J. (Dermatologist), editor.
Title: Dermal fillers / volume editor, D.J. Goldberg.
Other titles: Aesthetic dermatology (Series) ; v. 4. 2235–8609
Description: Basel; New York : Karger, 2018. | Series: Aesthetic dermatology, ISSN 2235–8609 ; vol. 4 | Includes bibliographical references and indexes.
Identifiers: LCCN 2017039083| ISBN 9783318061246 (hard cover : alk. paper) | ISBN 9783318061253 (electronic version)
Subjects: | MESH: Dermal Fillers | Face--surgery | Injections, Subcutaneous | Cosmetic Techniques | Dermatologic Surgical Procedures
Classification: LCC RD119.5.F33 | NLM WE 705 | DDC 617.5/2059--dc23 LC record available at https://lccn.loc.gov/2017039083
 
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® .
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2018 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland)
www.karger.com
Printed on acid-free and non-aging paper (ISO 9706)
ISSN 2235–8609
e-ISSN 2235–8595
ISBN 978–3-318–06124-6
e-ISBN 978–3-318–06125-3
 
Contents
Preface
Goldberg, D.J. (New York, NY)
History of Fillers
Narins, R.S. (New York, NY); Mariwalla, K. (West Islip, NY)
Anatomy for Facial Fillers: The Skin Surface and Beyond
Sykes, J.; Allak, A. (Sacramento, CA); Palhazi, P. (Budapest); Cotofana, S. (Albany, NY)
Neocollagenesis
Handler, M.Z.; Goldberg, D.J. (New York, NY)
Hyaluronic Acid in Dermal Fillers
Goldie, K.; Voropai, D. (London)
Calcium Hydroxylapatite (Radiesse)
Friedmann, D.P. (Austin, TX)
Safe and Effective Injection Technique
Funt, D.K. (New York, NY)
Novel Use of Fillers (Chin, Nose, Hands)
Marmur, E. (New York, NY)
Soft Tissue Augmentation in the US
Nestor, M.S. (Aventura, FL/Miami, FL); Bass, A.M. (Aventura, FL); Gold, M.H. (Nashville, TN)
Complications of Cosmetic Fillers
Grunebaum, L.D. (Miami, FL); Funt, D.K. (New York, NY)
Author Index
Subject Index
 
Preface
 
It is now over 30 years since the initial bovine collagen dermal fillers became available. In the last 3 decades, a large variety of differentiated fillers have been introduced in the US and throughout the world. A book describing all the fillers available in Europe and Asia is not possible with the constant changes occurring almost monthly. Also, some potentially dangerous fillers have never reached the US because of strict FDA guidelines in the US. Therefore, this book will predominantly focus on dermal fillers available both in the US and in most of the world.
The initial fillers were solely collagen-based products. They were FDA cleared, and predominantly used in the nasolabial folds. Today not only are there fillers made of a variety of substances, but numerous facial and non-facial areas can be treated using them. In addition, our understanding of dermal filler mechanisms of action has been revolutionized in recent decades. Initially thought to simply “fill,” some fillers also induce neocollagenesis after treatment, with the potential for further benefit after the initial “fill.”
As expected, with increasing use of dermal fillers, more complications have been noted. Yet with better injection techniques and safety understanding, the incidence of complications has greatly decreased. In the initial chapters of the book, we will discuss the history of fillers, anatomy relative to filler injections, and filler-induced neocollagenesis. In subsequent chapters, we will discuss both hyaluronic acid and calcium hydroxyapatite fillers. The final chapters discuss the complications, injection techniques and safety, and novel use of fillers.
Enjoy.
David J. Goldberg , New York, NY
 
Goldberg DJ (ed): Dermal Fillers. Aesthet Dermatol. Basel, Karger, 2018, vol 4, pp 1–9 10.1159/000479132
______________________
History of Fillers
Rhoda S. Narins a · Kavita Mariwalla b
a Dermatology Surgery and Laser Center, New York, NY, and b Mariwalla Dermatology, West Islip, NY, USA
______________________
Abstract
The evolution of injectable facial fillers has come a long way from the time of injecting paraffin and Vaseline for facial augmentation. Patients today demand a filler material that is long lasting, affordable, biocompatible, and natural looking. The quest for the perfect injectable has taken an interesting course with most innovation taking place in the last 30 years. To understand the future of facial augmentation, it is important to look to the past for valuable lessons and tales of caution for progress to be a success. The proliferation of hyaluronic acid fillers is understandable in the context of materials that came before as is the caution used with permanent fillers. Skepticism remains with autologous fat transfer as the procedure has still not been perfected in a way that results can be reliably reproduced from physician to physician. Silicone, a permanent liquid filler, remains controversial and fillers such as calcium hydroxylapatite not only improve the appearance of volume loss but can also induce collagen formation. As the physician’s filler armamentarium increases, so does the desire to advance the actual techniques of injection itself. The end result has been an improvement in the technology of facial filling and the results.
© 2018 S. Karger AG, Base
To understand the current explosion in the filler market, it is important to understand its origins. From the copper and lead ore that the ancient Egyptians used as makeup to the scented oils meant to soften skin, the allure of youth has captivated cultures throughout the world for centuries. The drive to find the perfect facial filling agent has always centered on 3 main principles: safety, biocompatibility, and the ability to reflate the lost volume that accompanies time. Because procedures using fillers are cosmetic and elective, inherent in the safety profile is the understanding that fillers should not induce allergy, cause infection, or be carcinogenic or teratogenic. As the aesthetics of facial aging evolved, so too did the demands of the marketplace. Thus, there was an expectation that the new generation of fillers would stimulate a minimal immune response (thus, obviating the need for skin testing), provide a soft correction that was long lasting, and stay fixed without fear of migration of the product. In addition, the material should be easily dissolved, result in minimal edema, require no overcorrection, and be reasonably priced. Nowadays consumers want to not only fill deep hollows but also fine lines. To understand and appreciate the types of fillers available, one must understand the history of how this wish list came to be.
The First Filler
In 1830, German chemist Baron Karl Ludwig von Reichenbach discovered paraffin [ 1 ], created by the dry distillation of beech-wood tar. Because it was unreactive, von Reichenbach imagined it as a replacement for beeswax in candles. Though it may not have been what he originally intended, paraffin became popular in the medical community. At the University of Vienna, Theodur Billroth (1825–1899) used paraffin to lubricate resected joints. Paraffin was also used by dermatologists, as a vehicle to inject heavy metal salts as a treatment for syphilis. It was from the lineage of Billroth that the first cosmetic use of an injectable thus came to be; Robert Gersuny, one of Billroth’s pupils, injected liquid paraffin (mineral oil) in 1899 to create a testicular prosthesis in a patient who had been castrated for the purpose of treating tuberculous epididymitis [ 2 ].
Gersuny went on to experime