By Neil S. Sadick MD

Filler innovations are the main customary surgeries in plastic surgery, as they're the easiest approach to lowering wrinkles on a long term foundation. For years, dermatologists have recognized that water-binding soft-tissue fillers can change the lack of collagen, elastin, and hyaluronic acid from the outside. simply because filler formulation and alertness suggestions are continually up-to-date and reevaluated, the dermatologist and beauty doctor desire a speedy reference at the topic. This new textual content, edited via world-renowned dermatologist Dr. Neil S. Sadick, covers the entire major points of soft-tissue filler recommendations. topics coated contain identifying and utilizing fillers; short-, intermediate-, and long-acting fillers; and blend techniques, in addition to anesthetic issues, gear and sufferer positioning, operative techniques, power problems, and postoperative overview.

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Another method for convert- disturb the hydrophilicity and, therefore, the cos- ing the gel to a usable product is a homogenization metically desired lifting capacity by diminishing process, which produces a less granular product con- Although a higher degree of 4 water volume. 4 This urally occurring hyaluronic acids could theoretically method may lower the G# value and ease the extru- prompt an immune reaction, thereby producing sion process. Whatever method is employed to break 4 undesirable granules or abscesses.

1). The tissue formation observed was accompanied by evidence of clinical improvement at six months. 17 result is a highly biocompatible long-lasting implant with similar characteristics to adjacent tissue. Thus, Durability when CaHA is implanted in soft tissue, new soft Over time, the CaHA particles are metabolized 17 tissue develops. No calciÞcation or osteogenesis and removed through normal homeostatic pathways. has been reported in the extensive literature describ- In one long-term animal study, CaHA particles ing the use of CaHA in a variety of soft tissue remained intact at the site of injection throughout applications.

10 Evolence is yet robust dermal Þller has led to the development used for moderate-to-deep wrinkles and injected in of a new porcine-based dermal Þller, Evolence. This the deep dermis with a twenty-seven-gauge needle. It was developed in Haifa, Israel, by Colbar Corpora- is effective for correction of nasolabial folds and mar- tion, now a division of Johnson and Johnson. Rather ionette lines. Evolence does have a thinner, more than using mixed dermal collagen (types I, II, and III), reÞned companion product Ð Evolence Breeze Ð which this product uses only type I collagen harvested from is intended for more superÞcial placement and lip 36 Augmentation Fillers FIG.

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