软组织填充剂在美容皮肤科的应用

填充剂(fillers)也称软组织填充剂(soft tissue augmentation)是注射到皮肤内使皮肤凹陷、缺损得以填充,达到纠正缺陷,恢复完美皮肤目的所用的材料,这种技术问世已有一个多世纪,它确实能解决特别是面部种种疾病引起脂肪缺损的塌陷、面部不对称、严重影响生活质量的问题。虽然已有许多填充剂问世,但总的来说还是不太理想,需要进一步研制、开发新的产品。     

注射用软组织填充材料在美容外科的应用与发展

随着医学和生物科学技术的蓬勃发展,注射性软组织填充材料也不断改进和变革,因而在美容外科领域越来越发挥着重要的作用,我们就注射用软组织填充材料在美容外科应用和发展的情况做综述如下。     

透明质酸填充剂联合利多卡因面部填充的研究进展

透明质酸(hyaluronic acid,HA)填充剂是一种常用于面部年轻化的注射美容材料.为了减轻注射过程中的疼痛感及提高求美者对注射美容的接受度,较多的学者研究显示,将含有利多卡因的透明质酸(hyaluronic acid lidocaine,HAL)填充剂应用于面部老化的求美者中,其临床效果及安全性方面与单纯应用...     

注射用软组织填充物

注射液体或胶体来改善面部及身体的轮廓 ,以达到面容美和体型美的目的 ,是美容外科较为理想的方法。注射方法简单实用 ,易于掌握 ,形态容易控制。但这种方法对填充材料的要求很高 ,首先它要符合所有组织替代物的要求 ;其次其质地要接近正常软组织 ,注入后不宜流动到其他部位 ,如有并发症发生 ,易于取出。为了实现这一目的 ,百余年来外科和材料学方面的开发从未停止。特别是近 10年来 ,随着科学技术的快速发展 ,一大批新的注射填充材料相继出现。这些材料以各种各样的商品名出现在杂志、会议及相关网站上。有的在我国已获准应用于临床 ,有的…     

聚丙烯酰胺水凝胶软组织填充剂的实验研究

应用聚丙烯酰胺水凝胶行动物体内注入 ,了解其组织反应 ,包膜形成。利用健康家兔 ,实验组 :应用聚丙烯酰胺、头孢拉啶、利多卡因、生理盐水 ;对照组 :仅用头孢拉啶或庆大霉素、利多卡因、生理盐水注入后定期切除及切取活检 ,标本行光镜、电镜检查 ,肉眼观察。结果实验组炎症反应轻微 ,术后 1周即形成极薄的包膜 ,至 6个月虽有增厚 ,但仍较薄。对照组结果提示以庆大霉素反应较头孢霉素轻。该填充剂注入体内组织反应轻 ,包膜形成早 ,有利于临床应用。但对组织早期仍有一定的影响 ,应引起注意 ,同时在预防感染配合应用抗生素方面以庆大霉素为妥。     

聚丙烯酰胺水凝胶软组织填充剂的临床应用

目的：探讨聚丙烯酰胺水凝胶的临床应用情况。聚丙烯酰胺水凝胶作为一种新型软组织填充材料，自１９９７年引入我国，由于其卓越的理化特性及良好的临床疗效，受到病人及医生的青睐。     

注射用软组织填充物

注射液体或胶体来改善面部及身体的轮廓,以达到面容美和体型美的目的,是美容外科较为理想的方法.     

聚丙烯酰胺水凝胶软组织填充剂的临床应用

目的:探讨聚丙烯酰胺水凝胶的临床应用情况.聚丙烯酰胺水凝胶作为一种新型软组织填充材料,自1997年引入我国,由于其卓越的理化特性及良好的临床疗效,受到病人及医生的青睐.方法:利用该凝胶填充乳房、额颞部、面颊部、大腿、臀部等缺损凹陷部位100余处,获得理想疗效.结果:体会该填充剂操作简单、安全、局部反应轻.另就术后出现硬结及术后两侧不对称等情况分析了原因,提出了解决办法.报道60例不同缺损凹陷病例用该凝胶治疗,无1例并发症发生.结论:聚丙烯酰胺水凝胶是一种优良的软组织填充材料.     

Review of injectable materials for soft tissue augmentation

Although a variety of injectable agents are available for soft tissue augmentation, no perfect filler material exists. The advantages and disadvantages of commonly used materials such as bovine collagen have been well documented. However, many newer injectables are still undergoing experimentation to determine their clinical efficacy and long-term safety. This article details recent scientific work to compare injectable materials from the following categories: xenografts (bovine collagen and hyaluronic acid derivatives), autografts (autologous fat, Isolagen, and Autologen), homografts (Dermalogen and Cymetra), and synthetic materials (fluid silicone and Artecoll).     

The augmentation of soft tissue with injectable collagen

Clinical experience has demonstrated the value of injectable collagen in treating small soft-tissue defects. Among the lesions that respond best to injectable collagen therapy are nasolabial and glabellar lines as well as areas of atrophy and soft scars. This material is a useful adjunct to surgical procedures and can correct contour irregularities that may follow rhinoplasty or rhytidectomy. The safety of injectable collagen has also been well demonstrated. The nature and incidence of treatment reactions (less than 3 per cent) remains unchanged since the close of clinical trials. Reactions have been localized, and although some have been cosmetically undesirable, none has been health-threatening. All ultimately resolve without therapeutic intervention. Immunologic studies have confirmed the benign nature and specificity of reactions to injectable collagen. The importance of proper injection technique cannot be overstated. Immediately upon injection, tissue blanching followed by whealing and overcorrection should be evident. These indicate the desired superficial placement of the material. The overcorrection helps to compensate for the loss of carrier saline, and it quickly dissipates. When properly injected, injectable collagen can be used safely and effectively to correct an array of soft-tissue contour irregularities.     

Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation

While injectable fillers for facial-volume augmentation have been extensively marketed, there are few published reports comparing the clinical efficacy and cost-effectiveness of multiple injectable agents for soft-tissue augmentation in the face. We present our experience in 976 patients with the use of 4 common injectable agents: autologous fat, Hylaform, Restylane, and Radiesse. We analyzed the injection characteristics of each filler, including injection volume, complication rate, revision rate, and longevity, across 3 commonly treated anatomic regions: the nasolabial fold, glabella, and lips. We subsequently performed a detailed cost-effectiveness analysis of each filler in each anatomic region.Our results demonstrate that autologous fat transplantation is ideally suited for the treatment of the nasolabial fold and glabella, particularly in combination with other procedures. Fat grafting to the lips is limited to use as an adjunct to other facial surgery due to the prolonged recovery time required. We prefer Radiesse for the isolated treatment of the nasolabial folds and glabella. However, Radiesse is not recommended in the lips due to the increased incidence of complications. Last, the hyaluronic fillers Restylane and Hylaform have an excellent safety profile and are our first choice for isolated lip augmentation procedures.     

Overview: soft tissue augmentation

No single filler substance meets all of a clinician's expectations. There are, however, many substances currently available that are useful in the soft tissue armamentarium. This article reviews the many filler substances; their indications, shortcomings, complications, and approval status by the Federal Food and Drug Administration.     

Optimizing injectable poly-L-lactic acid administration for soft tissue augmentation: The rationale for three treatment sessions

BACKGROUND:

The availability and variety of different injectable modalities has led to a dramatic increase in soft tissue augmentation procedures in recent years. Injectable poly-L-lactic acid (PLLA) is a synthetic, biodegradable polymer device approved in the United States for use in immunocompetent patients as a single regimen of up to four treatment sessions for correction of shallow to deep nasolabial fold contour deficiencies and other facial wrinkles. Injectable PLLA is also approved for restoration and/or correction of signs of facial fat loss (lipoatrophy) in individuals with HIV.

METHODS:

The present article provides an overview of previous studies with injectable PLLA, and specifically focuses on the number of recommended treatment sessions and intervals between treatment sessions. The authors also provide two case studies to support their recommendations for an average of three treatment sessions.

RESULTS:

Although the specific mechanisms remain hypothetical, injections of PLLA are believed to cause a cascade of cellular events that lead to collagen repair and subsequent restoration of facial volume. Because the development of a response to injectable PLLA is gradual and its duration of effect is long lasting, sufficient time between treatment sessions should be allocated to avoid overcorrection.

CONCLUSION:

Studies of injectable PLLA support the hypothesized mode of operation, and the experience and clinical recommendations of the authors that suggest that three treatment sessions are an optimal regimen for use of injectable PLLA in the majority of patients.     

Evaluation of the Radiance FN soft tissue filler for facial soft tissue augmentation

OBJECTIVE: To evaluate the clinical efficacy and patient satisfaction of Radiance FN (fine needle) (BioForm Inc, Franksville, Wis), a highly biocompatible, calcium hydroxylapatite-based implant, when used for facial soft tissue augmentation. METHODS: Ninety patients aged between 25 and 85 years underwent subdermal injection with Radiance FN. The primary areas treated were lips, nasolabial folds, glabellar rhytids, marionette lines, prejowl depressions, acne scars, and surgical soft tissue defects. Patients were surveyed after treatment and for up to 6 months for pain, ecchymosis, skin erythema, nodules, softness, appearance, and satisfaction. RESULTS: In terms of efficacy, at 6 months, appearance, softness, and overall patient satisfaction were rated good or excellent in 74%, 80%, and 88% of patients, respectively. Moderate or severe pain occurred with injection in 59% of patients but disappeared 2 to 5 minutes after injection. Erythema, edema, and ecchymosis were common immediately after treatment but resolved in all patients within 2 weeks. Seven patients had persistent visible mucosal lip nodules, 4 of whom required intervention. CONCLUSIONS: Radiance FN is highly effective and well tolerated when used for facial soft tissue augmentation. Additional experience with longer follow-up will help determine the most appropriate use and long-term safety for the implant.     

Acellular human dermis for facial soft tissue augmentation.

The search for safe, permanent, and natural-appearing materials for soft tissue augmentation is ongoing. This article discusses two autologous dermal preparations available in injectable forms that do not cause cyst formation and its associated problems.     

四肢骨与软组织血管瘤研究进展

四肢骨与软组织血管瘤是一种良性的血管错构瘤,一般认为是由调节内皮细胞增殖的一个或多个基因发生突变,阻断凋亡诱导信号而抑制细胞凋亡所引起。明确诊断主要依据病理组织学检查,镜检可见由新生或异常血管腔形成的团块,与周围组织界限清楚。X线见静脉石、MRI有典型的血管流空信号也有重要诊断意义。将血管瘤和血管畸形病灶完整切除是根治血管瘤的唯一方法。术前对血管瘤,尤其是体积较大的蔓状血管瘤行供瘤动脉栓塞,可提高手术安全性和切除率。对于累及周围软组织的骨血管瘤,可采取一次性瘤段及受侵肌肉切除、植骨加吻合血管神经的游离肌皮瓣移植,以重建患肢功能。近年一些新的治疗方法如血管内注入硬化剂、激素治疗等,也取得不错的疗效。