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McCarthy AD, Hartmann C, Durkin A, Shahriar S, Khalifian S, Xie J. A morphological analysis of calcium hydroxylapatite and poly-l-lactic acid biostimulator particles. Skin Res Technol 2024; 30:e13764. [PMID: 38853456 PMCID: PMC11163027 DOI: 10.1111/srt.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/11/2024]
Abstract
Injectable fillers, pivotal in aesthetic medicine, have evolved significantly with recent trends favoring biostimulators like calcium hydroxylapatite (CaHA-CMC; Radiesse, Merz Aesthetics, Raleigh, NC) and poly-l-lactic acid (PLLA; Sculptra Aesthetics, Galderma, Dallas, TX). This study aims to compare the particle morphology of these two injectables and examine its potential clinical implications. Utilizing advanced light and scanning electron microscopy techniques, the physical characteristics of CaHA-CMC and PLLA particles were analyzed, including shape, size, circularity, roundness, aspect ratio, and quantity of phagocytosable particles. The findings reveal several morphological contrasts: CaHA-CMC particles exhibited a smooth, homogenous, spherical morphology with diameters predominantly ranging between 20 and 45 µm, while PLLA particles varied considerably in shape and size, appearing as micro flakes ranging from 2 to 150 µm in major axis length. The circularity and roundness of CaHA-CMC particles were significantly higher compared to PLLA, indicating a more uniform shape. Aspect ratio analysis further underscored these differences, with CaHA-CMC particles showing a closer resemblance to circles, unlike the more oblong PLLA particles. Quantification of the phagocytosable content of both injectables revealed a higher percentage of phagocytosable particles in PLLA. These morphological distinctions may influence the tissue response to each treatment. CaHA-CMC's uniform, spherical particles may result in reduced inflammatory cell recruitment, whereas PLLA's heterogeneous particle morphology may evoke a more pronounced inflammatory response.
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Affiliation(s)
| | | | - Alan Durkin
- Ocean Drive Plastic SurgeryVero BeachFloridaUSA
| | | | | | - Jingwei Xie
- University of Nebraska Medical CenterOmahaNebraskaUSA
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Porcello A, Chemali M, Marques C, Scaletta C, Lourenço K, Abdel-Sayed P, Raffoul W, Hirt-Burri N, Applegate LA, Laurent A. Dual Functionalization of Hyaluronan Dermal Fillers with Vitamin B3: Efficient Combination of Bio-Stimulation Properties with Hydrogel System Resilience Enhancement. Gels 2024; 10:361. [PMID: 38920908 PMCID: PMC11203111 DOI: 10.3390/gels10060361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
Hyaluronic acid (HA) hydrogels are commonly used for facial dermal filling and for alternative medical aesthetic purposes. High diversity exists in commercial formulations, notably for the optimization of finished product stability, functionality, and performance. Polyvalent ingredients such as calcium hydroxylapatite (CaHA) or vitamin B3 (niacinamide) are notably used as bio-stimulants to improve skin quality attributes at the administration site. The aim of the present study was to perform multi-parametric characterization of two novel cross-linked dermal filler formulas (HAR-1 "Instant Refine" and HAR-3 "Maxi Lift") for elucidation of the various functional impacts of vitamin B3 incorporation. Therefore, the HAR products were firstly comparatively characterized in terms of in vitro rheology, cohesivity, injectability, and resistance to chemical or enzymatic degradation (exposition to H2O2, AAPH, hyaluronidases, or xanthine oxidase). Then, the HAR products were assessed for cytocompatibility and in vitro bio-stimulation attributes in a primary dermal fibroblast model. The results showed enhanced resilience of the cohesive HAR hydrogels as compared to JUVÉDERM® VOLBELLA® and VOLUMA® reference products in a controlled degradation assay panel. Furthermore, significant induction of total collagen synthesis in primary dermal fibroblast cultures was recorded for HAR-1 and HAR-3, denoting intrinsic bio-stimulatory effects comparable or superior to those of the Radiesse® and Sculptra™ reference products. Original results of high translational relevance were generated herein using robust and orthogonal experimental methodologies (hydrogel degradation, functional benchmarking) and study designs. Overall, the reported results confirmed the dual functionalization role of vitamin B3 in cross-linked HA dermal fillers, with a significant enhancement of hydrogel system stability attributes and the deployment of potent bio-stimulatory capacities.
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Affiliation(s)
- Alexandre Porcello
- Development Department, LOUNA REGENERATIVE SA, CH-1207 Geneva, Switzerland; (C.M.); (K.L.)
| | - Michèle Chemali
- Plastic and Reconstructive Surgery, Ensemble Hospitalier de la Côte, CH-1110 Morges, Switzerland; (M.C.); (W.R.)
| | - Cíntia Marques
- Development Department, LOUNA REGENERATIVE SA, CH-1207 Geneva, Switzerland; (C.M.); (K.L.)
| | - Corinne Scaletta
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
| | - Kelly Lourenço
- Development Department, LOUNA REGENERATIVE SA, CH-1207 Geneva, Switzerland; (C.M.); (K.L.)
| | - Philippe Abdel-Sayed
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
- STI School of Engineering, Federal Polytechnical School of Lausanne, CH-1015 Lausanne, Switzerland
| | - Wassim Raffoul
- Plastic and Reconstructive Surgery, Ensemble Hospitalier de la Côte, CH-1110 Morges, Switzerland; (M.C.); (W.R.)
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
| | - Nathalie Hirt-Burri
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
| | - Lee Ann Applegate
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, CH-8057 Zurich, Switzerland
- Oxford OSCAR Suzhou Center, Oxford University, Suzhou 215123, China
| | - Alexis Laurent
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland; (C.S.); (P.A.-S.); (N.H.-B.); (L.A.A.)
- Manufacturing Department, LAM Biotechnologies SA, CH-1066 Epalinges, Switzerland
- Manufacturing Department, TEC-PHARMA SA, CH-1038 Bercher, Switzerland
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Munia CG, Parada M, Saito F. Do PLLA and HA potentially mimic estrogen effects in skin quality? J Cosmet Dermatol 2024; 23:1920-1921. [PMID: 38169140 DOI: 10.1111/jocd.16159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/23/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
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Fisher SM, Borab Z, Weir D, Rohrich RJ. The emerging role of biostimulators as an adjunct in facial rejuvenation: A systematic review. J Plast Reconstr Aesthet Surg 2024; 92:118-129. [PMID: 38518624 DOI: 10.1016/j.bjps.2024.02.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/09/2024] [Accepted: 02/27/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical modalities. Although volume augmentation has long been a focus of non-surgical facial rejuvenation, there is emerging interest in the use of biostimulators to induce physiologic changes in the skin. This article aimed to provide an overview of this class of therapies. METHODS A systematic review regarding the clinical use of biostimulatory agents including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) in facial rejuvenation was performed using PubMed databases. The protocol was developed following the preferred reporting for items for systematic reviews-protocols guidelines. Included studies matched predetermined criteria according to the employed intervention and outcomes. RESULTS The systematic review was performed in September 2023, with the primary search yielding 464 articles. Abstract review resulted in 73 articles of potential relevance. Comprehensive review of the articles and manual reference checks were performed, independently, by 2 authors. This yielded a total of 45 articles that met the inclusion criteria. CONCLUSIONS There is an increasing role for non-surgical modalities in facial rejuvenation. Biostimulatory agents may be used as an alternative, or act as an adjunct, to other non-surgical modalities. These agents induce physiologic changes that mitigate facial aging. There is limited, quantifiable data, which fully illustrate the effect in these products. Although these agents are known to illicit inflammatory changes, more controlled studies are needed to better elucidate the biostimulatory capacity of such non-surgical treatments.
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Affiliation(s)
- Sean M Fisher
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - Zachary Borab
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - David Weir
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA
| | - Rod J Rohrich
- Dallas Plastic Surgery Institute, 9101 N Central Expy, Dallas, TX 75225, USA.
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Ziade G, Daou D, Karam D, Tsintsadze M. The third generation barbed lifting threads: Added value of hyaluronic acid. J Cosmet Dermatol 2024; 23:186-192. [PMID: 37466136 DOI: 10.1111/jocd.15885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Facial thread lifting is a highly demanded procedure in esthetic clinics worldwide. The aim of this retrospective study is to evaluate the clinical effectiveness and overall patients' satisfaction of a new generation of barbed threads, in which a hyaluronic acid (HA) coat was added to the PLLA/PCL threads and compare the results with PLLA/PCL threads without HA. MATERIALS AND METHODS Twenty patients treated with the PLLA/PCL threads with or without hyaluronic acid (HA) were compared for FaceQ scales: Age appraisal, psychological function, skin satisfaction, satisfaction with facial appearance, appraisal lines of nasolabial folds, satisfaction of lower face, and jaw were compared at baseline, 4 and 12 months post-treatment. Early impact on life and the skin adverse effects were assessed 1 week post-treatment. Finally, patients and two physicians provided the GAIS score at 4 and 12 months and a comparison was made between the two groups. RESULTS There was a statistically significant improvement in all scales of FaceQ for all included patients at baseline and at 4 and 12 months post-treatment. Importantly, there were less skin-related adverse effects such as skin redness, uneven tone, irregular surface, burning, and itching sensation at a recovery period (1 week post-treatment) in the group receiving HA-containing threads. CONCLUSION A notably higher long-term improvement in aging appearance, satisfaction with face appearance, lower jaw and face as well as GAIS was seen in the group treated with HA-containing threads compared to the other treatment arm.
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Affiliation(s)
- Georges Ziade
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | - Dayane Daou
- Department of Anesthesia, American University of Beirut Medical Center-Beirut-Lebanon, Beirut, Lebanon
| | - Desiree Karam
- Faculty of Medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Murat Tsintsadze
- Clinic of Plastic and Aesthetic Surgery and Cosmetology Total Charm, Tbilisi, Georgia
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Nowag B, Schäfer D, Hengl T, Corduff N, Goldie K. Biostimulating fillers and induction of inflammatory pathways: A preclinical investigation of macrophage response to calcium hydroxylapatite and poly-L lactic acid. J Cosmet Dermatol 2024; 23:99-106. [PMID: 37593832 DOI: 10.1111/jocd.15928] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/02/2023] [Accepted: 06/29/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Initial macrophage response to biostimulatory substances is key in determining the subsequent behavior of fibroblasts and the organization of newly synthesized collagen. Though histological studies suggest that calcium hydroxylapatite (CaHA) filler initiates a regenerative healing response with collagen and elastin deposition similar to natural, healthy tissue rather than an inflammatory response with fibrosis, the relative activity of macrophages stimulated by CaHA, as well as how this activity compares to that induced by other biostimulatory fillers, has not been explored. The aim of the study is to characterize the in vitro macrophage response to two biostimulory fillers, CaHA and PLLA (poly-L lactic acid), and to evaluate their inflammatory potential. METHODS Primary human macrophages were incubated with two dilutions (1:50 and 1:100) of commercially available CaHA or PLLA. After 24 h incubation, an inflammation array was used to screen for the expression of 40 cytokines, released by macrophages. ELISA was used to confirm array results. RESULTS Four cytokines were significantly upregulated in M1 macrophages incubated with PLLA compared to both unstimulated controls and CaHA: CCL1 (p < 0.001), TNFRII (p < 0.01), MIP-1α (p < 0.05), and IL-8 (p < 0.001). In M2 macrophages, MIP-1α (p < 0.01) and MIP-1β (p < 0.01) were significantly upregulated by PLLA compared to CaHA and unstimulated controls. CONCLUSION Together, these findings indicate that the CaHA mode of action is a non-inflammatory response while PLLA initiates expression of several cytokines known to play a role in inflammation. Our study supports the concept that these two "biostimulatory" fillers follow distinct pathways and should be considered individually with regard to mechanism of action.
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Affiliation(s)
| | | | - Thomas Hengl
- R&D, Merz Aesthetics GmbH, Frankfurt am Main, Germany
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Chuang FJ, Wang YW, Chang LR, Chang CY, Cheng HY, Kuo SM. Enhanced skin neocollagenesis through the transdermal delivery of poly-L-lactic acid microparticles by using a needle-free supersonic atomizer. BIOMATERIALS ADVANCES 2023; 154:213619. [PMID: 37703788 DOI: 10.1016/j.bioadv.2023.213619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/23/2023] [Accepted: 09/03/2023] [Indexed: 09/15/2023]
Abstract
In this study, a spindle-type nozzle was designed to accelerate poly-L-lactic acid (PLLA) microparticles to supersonic velocities for the transdermal delivery of these microparticles to rats. This approach is needle- and pain-free and enhances skin collagen regeneration. The addition of PLLA microparticles at a concentration of 2 mg/mL did not hinder the growth of 3 T3 fibroblasts and Raw264.7 macrophages. The TNF-α assay revealed no obvious inflammation effect of PLLA microparticles at a concentration of 1 mg/mL. A time-lapse recording revealed that after being cocultured with PLLA microparticles for 24 h, Raw264.7 macrophages gradually approached and surrounded the PLLA microparticles. When 3 T3 fibroblasts were cocultured with Raw264.7 macrophages, which were stimulated using PLLA microparticles, collagen synthesis was increased by approximately 60 % compared with that in samples without PLLA microparticles. In vivo animal experiments indicated that after the transdermal delivery of 10 shots of PLLA microparticles through the supersonic atomizer, no obvious changes or damage to the back skin of Sprague-Dawley rats was observed. More importantly, numerous PLLA microparticles penetrated the rat epidermis into the dermal layer. We found macrophages and fibroblasts present close to the PLLA microparticles. Moreover, only mild or no inflammation reaction was observed. Masson staining revealed that after 6-week implantation, 6 % and 12 % of PLLA microparticles significantly stimulated collagen regeneration in 6-week-old and 32-week-old rats. In addition, picrosirius red staining revealed a significant increase in collagen regeneration, especially for type III collagen, following the 6-week implantation of PLLA microparticles. In summary, this study demonstrated an easy, pain-free, nondestructive approach for introducing PLLA microparticles into the dermal layer by using a supersonic atomizer to stimulate collagen regeneration in vivo.
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Affiliation(s)
- Feng-Ju Chuang
- Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan; Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Wen Wang
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Li-Ren Chang
- Department of Plastic and Reconstructive Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Biomedical Engineering, College of Medical Science and Technology, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Yi Chang
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Hsia-Ying Cheng
- Indigenous Program of the College of Tourism and Hospitality, I-Shou University, Kaohsiung, Taiwan
| | - Shyh-Ming Kuo
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.
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8
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Han WY, Kim HJ, Kwon R, Kang SM, Yon DK. Safety and Efficacy of Poly-L-Lactic Acid Filler (Gana V vs. Sculptra) Injection for Correction of the Nasolabial Fold: A Double-Blind, Non-Inferiority, Randomized, Split-Face Controlled Trial. Aesthetic Plast Surg 2023; 47:1796-1805. [PMID: 37626137 DOI: 10.1007/s00266-023-03600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Poly-L-lactic acid (PLLA) fillers have shown excellent results as soft tissue fillers for progressive midface volume enhancement, with long-lasting results and high patient satisfaction. OBJECTIVE Herein, we investigated the safety and effectiveness of a new PLLA filler (Gana V) in comparison with those of the widely used Sculptra. METHODS This double-blind, non-inferiority, randomized, split-face controlled trial was performed in France to evaluate the safety and effectiveness of injectable Gana V compared with those of Sculptra for correction of nasolabial fold (NLF) depression. The primary outcome was improvement in NLFs, as determined using the Wrinkle Severity Rating Scale (WSRS). This trial is an interim report of the results at 6 months. The trial was registered at ClinicalTrials. gov, number NCT05215054. RESULTS Fifty-five participants with moderate-to-severe NLFs (mean age 53.8 [standard deviation 8.7] years; 48 [87.3%]) female) were enrolled. After 6 months, Gana V showed improved WSRS score (mean difference - 0.25; 95% confidence interval [CI] - 0.49 to - 0.01) in intention-to-treat analysis, while Sculptra did not (mean difference - 0.20; 95% CI - 0.42 to 0.03). Furthermore, Gana V showed an acceptable 6-month effectiveness compared with Sculptra, within our defined non-inferiority margin (pnon-inferiority = 0.1787). The immediate results by the investigator after the initial injection showed higher satisfaction in the Gana V than in the Sculptra group. Gana V and Sculptra showed no difference in adverse reactions. Similar patterns were observed in per-protocol analyses. CONCLUSIONS Gana V is non-inferior to Sculptra with respect to the correction of NLFs and has higher investigator satisfaction. Further research is required to ensure long-term safety. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Woo Yeon Han
- Department of Plastic and Reconstructive Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seoul, 16995, South Korea.
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea
| | - So Min Kang
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea.
- KBI Korea Biomedical research Institute, Seongnam, South Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Seoul, 02447, South Korea.
- Department of Regulatory Science, Kyung Hee University , Seoul, South Korea.
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9
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McCarthy AD, Soares DJ. Letter to the Editor: Post hoc analysis of "Clinical and histological comparative outcomes after injections of poly-L-lactic acid and calcium hydroxyapatite in arms: A split side study". J Cosmet Dermatol 2023; 22:2871-2873. [PMID: 37194938 DOI: 10.1111/jocd.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 05/18/2023]
Affiliation(s)
| | - Danny J Soares
- American Foundation for Aesthetic Medicine (AFFAM), Fruitland Park, Florida, USA
- University of Central Florida, College of Medicine, Orlando, Florida, USA
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Aguilera SB, McCarthy A, Khalifian S, Lorenc ZP, Goldie K, Chernoff WG. The Role of Calcium Hydroxylapatite (Radiesse) as a Regenerative Aesthetic Treatment: A Narrative Review. Aesthet Surg J 2023; 43:1063-1090. [PMID: 37635437 PMCID: PMC11025388 DOI: 10.1093/asj/sjad173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
For decades, a wide variety of natural and synthetic materials have been used to augment human tissue to improve aesthetic outcomes. Dermal fillers are some of the most widely used aesthetic treatments throughout the body. Initially, the primary function of dermal fillers was to restore depleted volume. As biomaterial research has advanced, however, a variety of biostimulatory fillers have become staples in aesthetic medicine. Such fillers often contain a carrying vehicle and a biostimulatory material that induces de novo synthesis of major structural components of the extracellular matrix. One such filler, Radiesse (Merz Aesthetics, Raleigh, NC), is composed of calcium hydroxylapatite microspheres suspended in a carboxymethylcellulose gel. In addition to immediate volumization, Radiesse treatment results in increases of collagen, elastin, vasculature, proteoglycans, and fibroblast populations via a cell-biomaterial-mediated interaction. When injected, Radiesse acts as a cell scaffold and clinically manifests as immediate restoration of depleted volume, improvements in skin quality and appearance, and regeneration of endogenous extracellular matrices. This narrative review contextualizes Radiesse as a regenerative aesthetic treatment, summarizes its unique use cases, reviews its rheological, material, and regenerative properties, and hypothesizes future combination treatments in the age of regenerative aesthetics. LEVEL OF EVIDENCE: 5
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Affiliation(s)
| | - Alec McCarthy
- Corresponding Author: Dr Alec McCarthy, Medical Affairs North America, Merz Aesthetics, 6501 Six Forks Road, Raleigh, NC 27615, USA. E-mail:
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Guo J, Fang W, Wang F. Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives. RSC Adv 2023; 13:23841-23858. [PMID: 37577103 PMCID: PMC10413051 DOI: 10.1039/d3ra04321e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
With the increasing understanding of the aging process and growing desire for minimally invasive treatments, injectable fillers have great potential for correcting and rejuvenating facial wrinkles/folds and contouring the face. However, considering the increasing availability of multiple soft tissue fillers, it is important to understand their inherent biophysical features and specific mechanism. Thus, in this review, we aim to provide an update on the current injectable filler products and analyze and compare their critical physicochemical properties and function mechanisms for volume-filling. Additionally, future trends and development processes for injectable fillers are also proposed.
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Affiliation(s)
- Jiahong Guo
- Yunnan Botanee Bio-technology Group Co., Ltd. Yunnan 650106 China
- Shanghai Jiyan Bio-pharmaceutical Co., Ltd. Shanghai 201702 China
| | - Wei Fang
- Yunnan Yunke Characteristic Plant Extraction Laboratory Co., Ltd. Yunnan 650106 China
- Medaesthee (Shanghai) Biotechnology Co., Ltd. Shanghai. 201700 China
| | - Feifei Wang
- Yunnan Botanee Bio-technology Group Co., Ltd. Yunnan 650106 China
- Shanghai Jiyan Bio-pharmaceutical Co., Ltd. Shanghai 201702 China
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12
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Oh S, Lee JH, Kim HM, Batsukh S, Sung MJ, Lim TH, Lee MH, Son KH, Byun K. Poly-L-Lactic Acid Fillers Improved Dermal Collagen Synthesis by Modulating M2 Macrophage Polarization in Aged Animal Skin. Cells 2023; 12:cells12091320. [PMID: 37174720 PMCID: PMC10177436 DOI: 10.3390/cells12091320] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Poly-L-lactic acid (PLLA) fillers correct cutaneous volume loss by stimulating fibroblasts to synthesize collagen and by augmenting the volume. PLLA triggers the macrophage-induced activation of fibroblasts that secrete transforming growth factor-β (TGF-β). However, whether M2 macrophage polarization is involved in PLLA-induced collagen synthesis via fibroblast activation in aged skin is not known. Therefore, we evaluated the effect of PLLA on dermal collagen synthesis via M2 polarization in an H2O2-induced cellular senescence model and aged animal skin. H2O2-treated macrophages had increased expression levels of the M1 marker CD80 and decreased expression levels of the M2 marker CD163, which were reversed by PLLA. The expression levels of interleukin (IL)-4 and IL-13, which mediate M2 polarization, were decreased in H2O2-treated macrophages and increased upon the PLLA treatment. CD163, IL-4, and IL-13 expression levels were decreased in aged skin, but increased after the PLLA treatment. The expression levels of TGF-β, pSMAD2/SMAD2, connective tissue growth factor (CTGF), alpha-smooth muscle actin (α-SMA), collagen type 1A1 (COL1A1), and COL3A1 were also decreased in aged skin, but increased after the PLLA treatment. Moreover, PLLA upregulated phosphatidylinositol 3-kinase p85α (PI3-kinase p85α)/protein kinase B (AKT) signaling, leading to fibroblast proliferation. PLLA decreased the expression of matrix metalloproteinase (MMP) 2 and MMP3, which destroy collagen and elastin fibers in aged skin. The amount of collagen and elastin fibers in aged skin increased following the PLLA treatment. In conclusion, PLLA causes M2 polarization by increasing IL-4 and IL-13 levels and upregulating TGF-β expression and collagen synthesis in aged skin.
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Affiliation(s)
- Seyeon Oh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
| | - Je Hyuk Lee
- Doctorbom Clinic, Seoul 06614, Republic of Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Republic of Korea
| | - Hyoung Moon Kim
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Republic of Korea
| | - Sosorburam Batsukh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Republic of Korea
| | | | | | | | - Kuk Hui Son
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University, Incheon 21565, Republic of Korea
| | - Kyunghee Byun
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
- Department of Anatomy & Cell Biology, Gachon University College of Medicine, Incheon 21936, Republic of Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health & Sciences and Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea
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Oh S, Seo SB, Kim G, Batsukh S, Son KH, Byun K. Poly-D,L-Lactic Acid Stimulates Angiogenesis and Collagen Synthesis in Aged Animal Skin. Int J Mol Sci 2023; 24:ijms24097986. [PMID: 37175693 PMCID: PMC10178436 DOI: 10.3390/ijms24097986] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Angiogenesis promotes rejuvenation in multiple organs, including the skin. Heat shock protein 90 (HSP90), hypoxia-inducible factor-1 alpha (HIF-1α), and vascular endothelial growth factor (VEGF) are proangiogenic factors that stimulate the activities of phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and extracellular signal-regulated kinase 1/2 (ERK1/2). Poly-D,L-lactic acid (PDLLA), polynucleotide (PN), and calcium hydroxyapatite (CaHA) are dermal fillers that stimulate the synthesis of dermal collagen. However, it is not yet known whether these compounds promote angiogenesis, which leads to skin rejuvenation. Here, we evaluated whether PDLLA, PN, and CaHA stimulate angiogenesis and skin rejuvenation using H2O2-treated senescent macrophages and endothelial cells as an in vitro model for skin aging, and we used young and aged C57BL/6 mice as an in vivo model. Angiogenesis was evaluated via endothelial cell migration length, proliferation, and tube formation after conditioned media (CM) from senescent macrophages was treated with PDLLA, PN, or CaHA. Western blot showed decreased expression levels of HSP90, HIF-1α, and VEGF in senescent macrophages, but higher expression levels of these factors were found after treatment with PDLLA, PN, or CaHA. In addition, after exposure to CM from senescent macrophages treated with PDLLA, PN, or CaHA, senescent endothelial cells expressed higher levels of VEGF receptor 2 (VEGFR2), PI3K, phosphorylated AKT (pAKT), and phosphorylated ERK1/2 (pERK1/2) and demonstrated greater capacities for cell migration, cell proliferation, and tube formation. Based on the levels of 4-hydroxy-2-nonenal, the oxidative stress level was lower in the skin of aged mice injected with PDLLA, PN, or CaHA, while the tumor growth factor (TGF)-β1, TGF-β2, and TGF-β3 expression levels; the density of collagen fibers; and the skin elasticity were higher in the skin of aged mice injected with PDLLA, PN, or CaHA. These effects were greater in PDLLA than in PN or CaHA. In conclusion, our results are consistent with the hypothesis that PDLLA stimulates angiogenesis, leading to the rejuvenation of aged skin. Our study is the first to show that PDLLA, PN, or CaHA can result in angiogenesis in the aged skin, possibly by increasing the levels of HSP90, HIF-1α, and VEGF and increasing collagen synthesis.
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Affiliation(s)
- Seyeon Oh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
| | - Suk Bae Seo
- SeoAh Song Dermatologic Clinic, Seoul 05557, Republic of Korea
| | - Gunpoong Kim
- VAIM Co., Ltd., Okcheon 29055, Republic of Korea
| | - Sosorburam Batsukh
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
- Department of Anatomy & Cell Biology, College of Medicine, Gachon University, Incheon 21936, Republic of Korea
| | - Kuk Hui Son
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University, Incheon 21565, Republic of Korea
| | - Kyunghee Byun
- Functional Cellular Networks Laboratory, Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Republic of Korea
- Department of Anatomy & Cell Biology, College of Medicine, Gachon University, Incheon 21936, Republic of Korea
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health & Sciences and Technology (GAIHST), Gachon University, Incheon 21999, Republic of Korea
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Chen L, Huang X, Chen H, Bao D, Su X, Wei L, Hu N, Huang W, Xiang Z. Hypoxia-mimicking scaffolds with controlled release of DMOG and PTHrP to promote cartilage regeneration via the HIF-1α/YAP signaling pathway. Int J Biol Macromol 2023; 226:716-729. [PMID: 36526060 DOI: 10.1016/j.ijbiomac.2022.12.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Abstract
Efficiently driving chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) while avoiding undesired hypertrophy remains a challenge in the field of cartilage tissue engineering. Here, we report the sequential combined application of dimethyloxalylglycine (DMOG) and parathyroid hormone-related protein (PTHrP) to facilitate chondrogenesis and prevent hypertrophy. To support their delivery, poly(lactic-co-glycolic acid) (PLGA) microspheres were fabricated using a double emulsion method. Subsequently, these microspheres were incorporated onto a poly(l-lactic acid) (PLLA) scaffold with a highly porous structure, high interconnectivity and collagen-like nanofiber architecture to construct a microsphere-based scaffold delivery system. These functional constructs demonstrated that the spatiotemporally controlled release of DMOG and PTHrP effectively mimicked the hypoxic microenvironment to promote chondrogenic differentiation with phenotypic stability in a 3D culture system, which had a certain correlation with the interaction between hypoxia-inducible Factor 1 alpha (HIF-1α) and yes-associated protein (YAP). Subcutaneous implantation in nude mice revealed that the constructs were able to maintain cartilage formation in vivo at 4 and 8 weeks. Overall, this study indicated that DMOG and PTHrP controlled-release PLGA microspheres incorporated with PLLA nanofibrous scaffolds provided an advantageous 3D hypoxic microenvironment for efficacious and clinically relevant cartilage regeneration and is a promising treatment for cartilage injury.
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Affiliation(s)
- Li Chen
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiao Huang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Hong Chen
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Dingsu Bao
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Xudong Su
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Li Wei
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ning Hu
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Wei Huang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
| | - Zhou Xiang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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15
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Mazzuco R, Evangelista C, Gobbato DO, de Almeida LM. Clinical and histological comparative outcomes after injections of poly-L-lactic acid and calcium hydroxyapatite in arms: A split side study. J Cosmet Dermatol 2022; 21:6727-6733. [PMID: 36098704 DOI: 10.1111/jocd.15356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/22/2022] [Accepted: 08/30/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although much has been published on the use of poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA) for off-face indications, questions remain regarding their exact mechanisms of action in subcutaneous tissue and their comparative efficacy. OBJECTIVE To present the clinical and histological results of the PLLA and CaHA injections into the opposing arms of the same patients. METHODS Five women received superficial subcutaneous injections of PLLA into the left arm and CaHA into the right arm. After three sessions, the clinical and histological outcomes were analyzed. RESULTS After the first session, three patients showed improvement in the right arm (CaHA), but at the end of study, two patients showed better results in the left arm (PLLA). Histologically, moderate to intense lymphocytic and giant cell infiltrate, as well as collagen and elastic fiber neoformation, were observed equally near the particles of both products. Dermis had no inflammatory or fiber alterations. CONCLUSION In this study, there were no clinical differences between these two fillers. Despite current thinking and previous histological studies, we found both products produced moderate to intense inflammatory reaction, as well as collagenic/elastogenic fiber neoformation, only in the subcutaneous tissue of the immediate vicinity and surrounding the individual filler particles.
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Affiliation(s)
- Rosemarie Mazzuco
- Private Clinic, Carazinho, Rio Grande do Sul and Mato Grosso, Brazil
| | | | | | - Luiz Mauricio de Almeida
- School of Medical Sciences, Santa Casa of Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
- Dermatology Residency Preceptor, Santa Casa of Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
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Abstract
BACKGROUND Regenerative aesthetics is an emerging branch of regenerative medicine with therapies aimed at recapturing youthful structure and function using the body's own systems. OBJECTIVE To introduce the field of regenerative aesthetics, and to explore themes and evidence surrounding current and emerging therapies in the field. MATERIALS AND METHODS A review of the literature was performed for each of the 3 pillars of regeneration; namely, stem cells, biochemical cues, and scaffolds. RESULTS Herein, we provide an overview of the field of regenerative aesthetics, a discussion surrounding the 3 pillars of regeneration, and an overview of the evidence supporting current and emerging therapeutic modalities that could play a pivotal role in the future of aesthetic treatments. CONCLUSION An enhanced understanding of this field can serve to further enhance our awareness about the regenerative effects of therapies we already offer, in addition to providing inspiration for future innovation.
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Zhang Y, Liang H, Luo Q, Chen J, Zhao N, Gao W, Pu Y, He B, Xie J. In vivo inducing collagen regeneration of biodegradable polymer microspheres. Regen Biomater 2021; 8:rbab042. [PMID: 34408912 PMCID: PMC8364987 DOI: 10.1093/rb/rbab042] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 12/26/2022] Open
Abstract
Biodegradable polymer particles have been used as dermal fillers for pre-clinical and clinical trials. The impact of material properties of polymers is very important to develop products for aesthetic medicine such as dermal fillers. Herein, eight biodegradable polymers with different molecular weights, chemical compositions or hydrophilic-hydrophobic properties were prepared and characterized for systematical study for aesthetic medicine applications. Polymer microspheres with 20-100 μm were prepared. The in vitro degradation study showed that poly (L-lactic-co-glycolic acid) 75/25 microspheres degraded the fastest, whereas poly (L-lactic acid) (PLLA) microspheres with intrinsic viscosity of 6.89 ([η] = 6.89) with the highest molecular weight showed the slowest degradation rate. After these microspheres were fabricated dermal fillers according to the formula of Sculptra®, they were injected subcutaneously into the back skin of rabbits. In vivo results demonstrated that the degradation rate of microspheres strongly correlated with the foreign body reaction and collagen regeneration was induced by microspheres. The microspheres with faster degradation rate induced inflammatory response and the collagen regeneration maintained in shorter time. PLLA ([η] = 3.80) microsphere with a moderate molecular weight and degradation rate could strongly regenerate Type I and III collagen to maintain a long-term aesthetic medicine effect. These properties of size, morphology and degradation behavior would influence the foreign body reaction and collagen regeneration.
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Affiliation(s)
- Yixin Zhang
- School of Smart Health, Chongqing College of Electronic Engineering, Chongqing 401331, China
| | - Hanwen Liang
- School of Laboratory Medicine, Sichuan Provincial Engineering Laboratory for Prevention and Control Technology of Veterinary Drug Residue in Animal-origin Food, Chengdu Medical College, Chengdu 610500, China
| | - Qian Luo
- School of Laboratory Medicine, Sichuan Provincial Engineering Laboratory for Prevention and Control Technology of Veterinary Drug Residue in Animal-origin Food, Chengdu Medical College, Chengdu 610500, China
| | - Jianlin Chen
- School of Laboratory Medicine, Sichuan Provincial Engineering Laboratory for Prevention and Control Technology of Veterinary Drug Residue in Animal-origin Food, Chengdu Medical College, Chengdu 610500, China
| | - Nan Zhao
- Puliyan (Nanjing) Medical Science & Technology Co. LTD, Nanjing 211500, China
| | - Wenxia Gao
- College of Chemistry and Materials Engineering, Wenzhou University, Wenzhou 325027, China
| | - Yuji Pu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Bin He
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Jing Xie
- Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
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18
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Kashiwada H, Shimizu Y, Sano Y, Yamauchi K, Guang H, Kumamoto H, Unuma H, Zhu YJ. In vivo behaviors of highly flexible paper consisting of ultralong hydroxyapatite nanowires. J Biomed Mater Res B Appl Biomater 2021; 109:1611-1621. [PMID: 33665970 DOI: 10.1002/jbm.b.34819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 11/05/2022]
Abstract
This study was conducted in order to investigate biological compatibility of a thin and flexible hydroxyapatite (HAP) paper which consists of ultralong hydroxyapatite nanowires. Circular-shaped cranial bone defects with a diameter of 8.8 mm were prepared to expose the dura maters in Wistar rats. The similar-sized, circular-shaped HAP paper was placed at the bottom of the bone defects. After 2, 4, and 8 weeks, the rats were sacrificed, and the experimental sections were examined by micro-CT scanning and histological observation. The HAP paper covered with fibrous tissues showed no inflammatory cell infiltration, and their thicknesses decreased over time. Tartrate-resistant acid phosphatase-positive osteoclast-like cells were induced around the edges of the HAP paper along with the exfoliation of the HAP paper. The newly-formed bones were observed in the bone-defected areas, either with a direct contact with the HAP paper or through thin fibrous tissues. The HAP paper-induced osteoblast differentiation was confirmed since the alkaline phosphatase activities were detected on the surfaces of the HAP paper. These results indicated that the HAP paper may induce osteogenesis without causing any harmful effects. The highly flexible HAP paper can contribute to further development of bone regenerative therapy.
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Affiliation(s)
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Graduate School of Dentistry, Sendai, Japan
| | - Yuya Sano
- Division of Oral Pathology, Graduate School of Dentistry, Sendai, Japan
| | | | - Hong Guang
- Division of International Collaborative and Innovative Dentistry, Tohoku University, Sendai, Miyagi, Japan
| | | | - Hidero Unuma
- Department of Chemistry and Chemical Engineering, Graduate School of Science and Engineering, Yamagata University, Yamagata, Japan
| | - Ying-Jie Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China
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Cho SW, Shin BH, Heo CY, Shim JH. Efficacy study of the new polycaprolactone thread compared with other commercialized threads in a murine model. J Cosmet Dermatol 2021; 20:2743-2749. [PMID: 33421303 PMCID: PMC8451902 DOI: 10.1111/jocd.13883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/15/2020] [Accepted: 12/01/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Polydioxanone (PDO) threads, poly-L-lactic acid (PLLA) threads, and polycaprolactone (PCL) threads have been used for lifting and antiaging purposes. The new PCL threads that have less residual monomer compared to the previous PCL are developed. AIMS The efficacy of threads regarding collagen synthesis and wrinkle improvement was evaluated in vivo model. METHODS In this study, threads were inserted into 30 six-week-old male SKH-1 hairless mice. One of four threads was implanted at either side of the spine of each mouse. Biopsy specimens obtained at 1, 4, and 8 weeks were examined using hematoxylin and eosin (H&E) and Herovici's stain. Additionally, immunoblot analysis was performed using primary antibody for collagen type III and transforming growth factor-β (TGF-β) and visualized by chemiluminescence and densitometric quantification. Finally, skin replicas were used to calculate total wrinkle area (mm2 ). RESULTS Neocollagenesis was significantly increased by 50% in the new PCL and pre-existing PCL groups at 8 weeks (p value < 0.001). Additionally, new-PCL-implanted mice showed a significant increase in collagen type III and TGF-β expressions at 8 weeks (p value < 0.001). The number of inflammatory cells was also increased in the skin of PCL-implanted mice at 8 weeks. Finally, wrinkles were reduced about 20% in the new PCL group at 8 weeks. CONCLUSIONS The new PCL thread exhibited a superior skin rejuvenation effect. This suggests that the material processing technology can be applied not only to the thread but also to various products such as dermal filler and cosmetics.
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Affiliation(s)
- Seung Woo Cho
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
| | - Byung Ho Shin
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
| | - Chan Yeong Heo
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
- Department of Plastic and Reconstructive SurgerySeoul National University College of MedicineSeoulKorea
| | - Jung Hee Shim
- Department of Plastic and Reconstructive SurgerySeoul National University Bundang HospitalSeongnamKorea
- Department of Research Administration TeamSeoul National University Bundang HospitalSeongnamKorea
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20
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Hexsel D, Camozzato F, Valente-Bezerra I, Silva AF, Siega C. L-Lift Technique Using Poly-l-Lactic Acid: A Pilot Study. Dermatol Surg 2021; 47:1087-1092. [PMID: 33988551 DOI: 10.1097/dss.0000000000003064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Minimally invasive procedures that prevent and delay the aging process can be an alternative to more invasive surgical procedures. OBJECTIVE To assess the efficacy and safety of L-Lift technique to improve skin firmness, facial global aesthetics, and the patient and investigator satisfaction. METHODS Prospective, open, single-center study. Thirty participants underwent 3 treatment sessions 1 month apart and were assessed 8, 16, and 24 weeks after first injections. Assessments included the Facial Laxity Rating Scale (FLRS), Global Aesthetic Improvement Scale (GAIS), objective measurement of skin elasticity, and the Skin Distension Test. RESULTS At Week 24, 60% of the patients had at least 1-class improvement in the FLRS for the middle face and 33% for the lower face. At Week 24, investigators considered that 90.0% of the patients improved according to the GAIS and 90.0% of the subjects considered they have improved. Skin elasticity (at Week 8 and at Week 16) and Skin Distension Test (at Week 24) assessments indicated improvement in skin firmness. Both patients and investigators were satisfied with the treatment at the study end. CONCLUSION The technique is safe and efficacious. It may be particularly suitable for patients presenting initial signs of facial skin laxity.
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Affiliation(s)
- Doris Hexsel
- All authors are affiliated with the Brazilian Center for Studies in Dermatology, Porto Alegre, RS, Brazil
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21
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Ray S, Adelnia H, Ta HT. Collagen and the effect of poly-l-lactic acid based materials on its synthesis. Biomater Sci 2021; 9:5714-5731. [PMID: 34296717 DOI: 10.1039/d1bm00516b] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Collagen is an important protein in various biological functions such as providing elasticity and waterproofing to the skin, structural stability to the cells in connective tissues (e.g. tendons, and bone) and stabilisation of atherosclerotic plaques. Collagen as a peptide with a peculiar triple helical structure is majorly composed of glycine and proline amino acids and is synthesised by fibroblasts via intracellular and extracellular mechanisms. Collagen plays an important role in wound healing, bone repair and plaque build-up during atherosclerosis. Various factors such as interleukins, insulin-like growth factor-I, nicotine, and glucose have been shown to influence collagen synthesis. This paper provides an overview of collagen structure, synthesis mechanisms, and the parameters that stimulate those mechanisms. Poly-l-lactic acid as a well-known biocompatible and biodegradable polymer has proved to stimulate collagen synthesis in various physical forms. As such, in this review special emphasis is laid on the effects of poly-l-lactic acid as well as its mechanism of action on collagen synthesis.
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Affiliation(s)
- Subarna Ray
- Queensland Micro- and Nanotechnology Centre, Griffith University, Brisbane, 4111, Queensland, Australia.
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22
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Carletto B, Koga AY, Novatski A, Mainardes RM, Lipinski LC, Farago PV. Ursolic acid-loaded lipid-core nanocapsules reduce damage caused by estrogen deficiency in wound healing. Colloids Surf B Biointerfaces 2021; 203:111720. [PMID: 33819820 DOI: 10.1016/j.colsurfb.2021.111720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/08/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
The skin aging process in women is accelerated due to decreases in serum estrogen levels triggered by the menopause process. Hence, poly(L-lactic acid) lipid-core nanocapsules containing ursolic acid (NPLA-UA) were developed using the interfacial deposition of the preformed polymer methodology as a strategy to reduce damages to the healing process caused by hormonal deficiency in ovariectomized rats. The colloidal suspensions of nanocapsules presented adequate size and morphology (254 and 375 nm), negative zeta potential (-31 and -37 mV), high encapsulation efficiency (99.89 %), and amorphous character. The analyses performed in an in vivo healing trial showed that the treatment with NPLA-UA resulted in faster wound retraction with less inflammatory response. In addition, the angiogenic process was stimulated increased synthesis of dermal collagen occurred. Ursolic acid-loaded, lipid-core nanocapsules are suitable for treating skin changes triggered by decreased estrogen in menopause.
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Affiliation(s)
- Bruna Carletto
- Postgraduate Program in Pharmaceutical Sciences, State University of Ponta Grossa, Paraná, Brazil.
| | - Adriana Yuriko Koga
- Postgraduate Program in Pharmaceutical Sciences, State University of Ponta Grossa, Paraná, Brazil
| | - Andressa Novatski
- Department of Physics, State University of Ponta Grossa, Paraná, Brazil
| | | | | | - Paulo Vitor Farago
- Department of Pharmaceutical Sciences, State University of Ponta Grossa, Paraná, Brazil
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Crowley JS, Kream E, Fabi S, Cohen SR. Facial Rejuvenation With Fat Grafting and Fillers. Aesthet Surg J 2021; 41:S31-S38. [PMID: 34002771 DOI: 10.1093/asj/sjab014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Facial rejuvenation requires a multi-modality approach to address the sun damage, volume loss, and thinning of skin that occurs with aging. With age, the collagen fibrils that provide strength become fragmented and fibroblasts connections become weak, leading to skin laxity and loss of youthful skin. Fillers can lead to a more youthful appearance by providing volumetric support. Synthetic fillers such as hyaluronic acid products, calcium hydroxyapatite, polylactic acid, and polymethylmethacralate have bio-stimulatory affects, ranging from small effects on fibroblast production to prolonged stimulatory effects on dermal thickness and blood supply. Fat grafting is also an ideal technique for facial rejuvenation because it is readily available, natural, and has regenerative effects. This review describes a new technique of fat grafting for the face called Injectable Tissue Replacement and Regeneration that specifically addresses the different anatomic compartments of the face with volume loss. With this brief review, we aim to evaluate the currents trends of fat grafting and fillers in the management of facial rejuvenation, including the cellular changes that occur with facial aging, the bio-stimulatory effects of fillers, and the anatomic replacement of tissue with fat grafting. >Level of Evidence: 4.
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Affiliation(s)
- J Sarah Crowley
- Division of Plastic Surgery, University of California San Diego, San Diego, CA, USA
| | - Elizabeth Kream
- Department of Dermatology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Sabrina Fabi
- Division of Dermatology, University of California San Diego, La Jolla, CA, USA
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24
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Mazzuco R, Dal'Forno T, Afonso Dini S. Subcutaneous Versus Supraperiosteal Injections of Poly-L-Lactic Acid: A Clinical and Imaging Study. Dermatol Surg 2021; 47:743-745. [PMID: 32769522 DOI: 10.1097/dss.0000000000002614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Taciana Dal'Forno
- Laser Department Coordinator of Brazilian Society of Dermatology, Cosmiatry Preceptor of Dermatology Service in Pontifícia Universidade Católica of Rio Grande do Sul, Porto Alegre, Brazil
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25
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Halepas S, Chen XJ, Ferneini EM. Thread-Lift Sutures: Anatomy, Technique, and Review of Current Literature. J Oral Maxillofac Surg 2020; 78:813-820. [DOI: 10.1016/j.joms.2019.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/27/2022]
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26
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Goldberg DJ. Stimulation of collagenesis by poly-L-lactic acid (PLLA) and -glycolide polymer (PLGA)-containing absorbable suspension suture and parallel sustained clinical benefit. J Cosmet Dermatol 2020; 19:1172-1178. [PMID: 32167231 DOI: 10.1111/jocd.13371] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Though the collagen-stimulating capacity of poly-L-lactic acid (PLLA) is well established, no data are available on collagen stimulation by the PLLA/PLGA within absorbable suspension sutures used for tissue repositioning. AIMS To characterize collagen stimulation by absorbable suspension sutures through examination of patient biopsies and assess severity of nasolabial folds (NLF) over time. PATIENTS/METHODS Single-center, open-label, prospective study of 25 healthy volunteers treated with absorbable suspension sutures for descent of midface tissues. Punch biopsies were collected and evaluated for total collagen content. Subject and investigators evaluated NLF severity using the Nasolabial Fold Wrinkle Assessment Score (NLF-WAS). Seventeen of 25 patients completed the collagenesis portion of the study. RESULTS Collagen deposition was apparent at day 90 and increased significantly compared with baseline at days 180 and 270 and between days 90 and 180. Subject- and investigator-reported NLF-WAS were significantly improved at all post-treatment time points through day 270. CONCLUSIONS Absorbable suspension sutures stimulate collagen in areas immediately adjacent to the path of the PLLA/PLGA monofilament and cones, providing mechanistic support for improvement in appearance observed in clinical studies. This neocollagenesis, coupled with repositioning by the suture's cones, makes absorbable suspension sutures a valuable tool for patients seeking facial rejuvenation.
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Affiliation(s)
- David J Goldberg
- Skin Laser & Surgery Specialists of NY/NJ, New York, New York.,Icahn School of Medicine at Mount Sinai, New York, New York.,NY Fordham Law School, New York, New York
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Kim HY, An BS, Kim MJ, Jeoung YJ, Byun JH, Lee JH, Oh SH. Signaling Molecule-Immobilized Porous Particles with a Leaf-Stacked Structure as a Bioactive Filler System. ACS Biomater Sci Eng 2020; 6:2231-2239. [PMID: 33455335 DOI: 10.1021/acsbiomaterials.9b01731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The ultimate purpose of this study was to develop a bioactive filler system that would allow volume restoration (passive property) and continuous release of signaling molecules to recruit soft tissues (bioactive property) and thus effectively correct facial aging. To achieve this, we prepared porous particles with a leaf-stacked structure throughout the entire particle volume (LSS particles) using a simple heating-cooling technique. LSS particles were loaded with insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF) separately, by immersing the particles in signaling molecule-containing solutions for target tissue recruitment (adipose by IGF-1 and blood vessels by VEGF). IGF-1 and VEGF were continuously released from LSS particles for 28 and 21 days in vitro, respectively, even without additional chemical/physical modifications, because of the unique morphology of the particles. Signaling molecules preserved their bioactivity in vitro (induction of adipogenic and angiogenic differentiation) and in vivo (recruitment of fat and blood vessels) for a sufficient period. Moreover, it was observed that the LSS particles themselves have stable volume retention characteristics in the body. Thus, we suggest that the signaling molecule-loaded LSS particles can function as a bioactive filler system for volume retention and target tissue regeneration.
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Affiliation(s)
- Ho Yong Kim
- Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Republic of Korea
| | - Bo Seul An
- Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Republic of Korea
| | - Min Ji Kim
- Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Republic of Korea
| | - Yeoung Jo Jeoung
- Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Republic of Korea.,Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea
| | - June-Ho Byun
- Department of Oral and Maxillofacial Surgery, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Jin Ho Lee
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea
| | - Se Heang Oh
- Department of Nanobiomedical Science, Dankook University, Cheonan 31116, Republic of Korea.,Center for Bio-Medical Engineering Core Facility, Dankook University, Cheonan 31116, Republic of Korea
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28
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Araco A. A prospective study comparing topic platelet-rich plasma vs. placebo on reducing superficial perioral wrinkles and restore dermal matrix. J COSMET LASER THER 2019; 21:309-315. [PMID: 31064236 DOI: 10.1080/14764172.2019.1605448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: The goal of our prospective study was to assess the efficacy of the topical Platelet-rich plasma on reducing superficial perioral wrinkles and restoring the dermal matrix. Materials and methods: 50 women with moderate to severe perioral wrinkles were treated on the perioral area by a single session of fractional CO2 laser skin resurfacing plus intradermal injection of prp. 25 patients (group 1) applied topically prp twice a day for 12 weeks as post laser treatment. 25 (group 2) applied gentamicin and betamethasone twice a day for the first 7 days and then hyaluronic acid gel for the following 12 weeks. Results: In group 1, moisture (p < 0.001), amount of collagen fiber (p < 0.001) skin elasticity (p < 0.001), PSAl (p < 0.001) and SSAl (p < 0.001) improved significantly. In group 2 all the parameters investigated improved but did not reach significant difference. Discussion: Our medical device with a plasma-like formulation is able to maintain prp active for a period of 7 days so patients are able to apply topically growth factors at home. Conclusions: Our prospective study proves that the use of topical prp reduces superficial perioral wrinkles and restore dermal matrix when used at home for 12 weeks.
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Affiliation(s)
- Antonino Araco
- Cosmetic Surgeon at Villa Salaria, private hospital , Rome , Italy
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29
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Manturova NE, Stenko AG, Petinati Y, Chaikovskaya EA, Bolgarina AA. Injectable collagen in correction of age-related skin changes: experimental and clinical parallels. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2019. [DOI: 10.24075/brsmu.2019.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To a large extent, age-related facial skin changes, wrinkles and flabbiness, are attributed to the structural alterations in dermis, including of collagen fibers fragmentation and disorganization. There are various cosmetological correction methods that aim to activate neocollagenesis and dermal remodeling. From this perspective, intradermal injections of exogenous collagen preparations seem logical. This study aimed to investigate the efficacy and safety of Collost 7% collagen complex applied to correct the age-related facial skin changes, as well as clarify the possible mechanisms of skin rejuvenation resulting from a course of intradermal injections. 35 participants entered the study, 30 of them finished it. A set of indicators describing age-related skin changes was assessed with the help of clinical scales; the assessment revealed a pronounced improvement in the quality of the patients' skin, including smoothed relief in the area of localization of fine wrinkles. The therapy resulted in a statistically significant improvement of the skin's elasticity, which, combined with the changes discovered through US scanning (greater dermis thickness and echodensity), is an indirect indication of skin restructuring associated with accumulation of fibrous protein structures. These results allow parallels with the experimental data that shows activation of neocollagenesis in the skin of laboratory animals after a course of Collost 7% gel. The research revealed no serious adverse events. A course of collagen administered intradermally can be recommended as an aesthetic correction procedure, as well as means of prevention of atrophy that has a significant effect on skin's appearance and health status.
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Affiliation(s)
- NE Manturova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - AG Stenko
- Institute of plastic surgery and cosmetology, Moscow, Russia
| | - YaA Petinati
- Izmerov Research Institute of Occupational Health, Moscow, Russia
| | - EA Chaikovskaya
- Institute of plastic surgery and cosmetology, Moscow, Russia
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30
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Kim CM, Kim BY, Hye Suh D, Lee SJ, Moon HR, Ryu HJ. The efficacy of powdered polydioxanone in terms of collagen production compared with poly-L-lactic acid in a murine model. J Cosmet Dermatol 2019; 18:1893-1898. [PMID: 30809959 DOI: 10.1111/jocd.12894] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 08/01/2018] [Accepted: 01/22/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND There are many collagen-stimulating fillers, including calcium hydroxyapatite, polycaprolactone (PCL), and poly-L-lactic acid (PLLA), and other materials have been tested. Polydioxanone (PDO) has recently been used as absorbable thread-lifting material due to its collagen-forming effects. PDO in powdered form is expected to be a good material for collagen-producing fillers. OBJECTIVES To evaluate the collagen-producing effects of powdered PDO injection compared with PLLA injection in a murine model. MATERIALS AND METHODS Powdered PDO mixed with sodium carboxymethyl cellulose, PLLA, and phosphate-buffered saline was injected on dorsal skin of 8-week-old rat. Tissue samples were obtained 1, 2, and 12 weeks after the procedures for histopathologic review and for real-time PCR to quantify collagen and tissue growth factors. RESULTS Both PLLA and powdered PDO injections induced granulomatous reactions. Collagen type 1, collagen type 3, TGF-β1, TGF-β2, and TGF-β3 showed increases 2 weeks after injection but decreased 12 weeks after injection for both powdered PDO and PLLA. CONCLUSION Our results suggested that powdered PDO injection induces collagen formation more effectively than PLLA injection. Therefore, PDO can be a good option for forming collagen.
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Affiliation(s)
- Chang Min Kim
- Department of Dermatology, Korea University Ansan Hospital, Korea University, Ansan, Korea
| | - Bo Young Kim
- Department of Dermatology, Korea University Ansan Hospital, Korea University, Ansan, Korea
| | | | | | - Hye Rim Moon
- Department of Dermatology, Korea University Ansan Hospital, Korea University, Ansan, Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University Ansan Hospital, Korea University, Ansan, Korea
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31
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Kim SA, Kim HS, Jung JW, Suh SI, Ryoo YW. Poly-L-Lactic Acid Increases Collagen Gene Expression and Synthesis in Cultured Dermal Fibroblast (Hs68) Through the p38 MAPK Pathway. Ann Dermatol 2019; 31:97-100. [PMID: 33911550 PMCID: PMC7992693 DOI: 10.5021/ad.2019.31.1.97] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 02/19/2018] [Accepted: 03/27/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sung-Ae Kim
- Department of Dermatology, School of Medicine & Institute for Medical Science, Keimyung University, Daegu, Korea
| | - Hyo-Seon Kim
- Department of Dermatology, School of Medicine & Institute for Medical Science, Keimyung University, Daegu, Korea
| | - Jin-Woong Jung
- Department of Dermatology, School of Medicine & Institute for Medical Science, Keimyung University, Daegu, Korea
| | - Sung-Il Suh
- Department of Microbiology, School of Medicine & Institute for Medical Science, Keimyung University, Daegu, Korea
| | - Young-Wook Ryoo
- Department of Dermatology, School of Medicine & Institute for Medical Science, Keimyung University, Daegu, Korea
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32
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O'Halloran NA, Dolan EB, Kerin MJ, Lowery AJ, Duffy GP. Hydrogels in adipose tissue engineering-Potential application in post-mastectomy breast regeneration. J Tissue Eng Regen Med 2018; 12:2234-2247. [PMID: 30334613 DOI: 10.1002/term.2753] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 10/02/2018] [Accepted: 10/15/2018] [Indexed: 12/11/2022]
Abstract
Current methods of breast reconstruction are associated with significant shortcomings, including capsular contracture, infection, rupture, the need for reoperation in implant-based reconstruction, and donor site morbidity in autologous reconstruction. These limitations result in severe physical and psychological issues for breast cancer patients. Recently, research has moved into the field of adipose tissue engineering to overcome these limitations. A wide range of regenerative strategies has been devised utilising various scaffold designs and biomaterials. A scaffold capable of providing appropriate biochemical and biomechanical cues for adipogenesis is required. Hydrogels have been widely studied for their suitability for adipose tissue regeneration and are advantageous secondary to their ability to accurately imitate the native extracellular matrix. The aim of this review was to analyse the use of hydrogel scaffolds in the field of adipose tissue engineering.
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Affiliation(s)
- Niamh A O'Halloran
- Discipline of Surgery, The Lambe Institute, National University of Ireland Galway, Galway, Ireland
| | - Eimear B Dolan
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.,Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin 2, Ireland.,Discipline of Anatomy, School of Medicine, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Michael J Kerin
- Discipline of Surgery, The Lambe Institute, National University of Ireland Galway, Galway, Ireland
| | - Aoife J Lowery
- Discipline of Surgery, The Lambe Institute, National University of Ireland Galway, Galway, Ireland
| | - Garry P Duffy
- Discipline of Anatomy, School of Medicine, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
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33
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Shin JJ, Park TJ, Kim BY, Kim CM, Suh DH, Lee SJ, Moon HR, Ryu HJ. Comparative effects of various absorbable threads in a rat model. J COSMET LASER THER 2018; 21:158-162. [DOI: 10.1080/14764172.2018.1493511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Jung Jin Shin
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Tae Jun Park
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Bo Young Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Min Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong Hye Suh
- Department of Dermatology, Arumdaun Nara Dermatologic Clinic, Seoul, Republic of Korea
| | - Sang Jun Lee
- Department of Dermatology, Arumdaun Nara Dermatologic Clinic, Seoul, Republic of Korea
| | - Hye-Rim Moon
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hwa Jung Ryu
- Department of Dermatology, Korea University College of Medicine, Seoul, Republic of Korea
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34
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Fitzgerald R, Bass LM, Goldberg DJ, Graivier MH, Lorenc ZP. Physiochemical Characteristics of Poly-L-Lactic Acid (PLLA). Aesthet Surg J 2018; 38:S13-S17. [PMID: 29897517 DOI: 10.1093/asj/sjy012] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Poly-L-lactic acid (PLLA) is a synthetic, biocompatible, biodegradable polymer. For soft-tissue augmentation, the size and chemical attributes of the PLLA microparticles are central to this agent's ability to promote a subclinical inflammatory response that stimulates deposition of collagen in the extracellular matrix. The resultant restoration of facial volume occurs in a controlled, predictable manner and is long lasting. The unique physiochemical and biostimulatory properties of PLLA differentiate it from other available treatments and are the foundation of the unique treatment methodology required for optimal results.
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Affiliation(s)
| | - Lawrence M Bass
- Department of Plastic Surgery, Manhattan Eye, Ear & Throat Hospital, Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - David J Goldberg
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, NY
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35
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Ramot Y, Haim-Zada M, Domb AJ, Nyska A. Biocompatibility and safety of PLA and its copolymers. Adv Drug Deliv Rev 2016; 107:153-162. [PMID: 27058154 DOI: 10.1016/j.addr.2016.03.012] [Citation(s) in RCA: 269] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 03/24/2016] [Accepted: 03/26/2016] [Indexed: 12/20/2022]
Abstract
PLA and its copolymers are commonly used for a wide variety of applications. While they are considered to be biocompatible, side effects resulting from their implantation have been reported. The implantation of biomaterials always results in a foreign body reaction. Such a reaction has also been reported following PLA and its copolymers. This article reviews the process of inflammatory reaction that is to be expected following implantation of PLA, and it highlights specific cases in which the inflammatory reaction can result in safety concerns. The authors also review selected cases from different medical fields to demonstrate possible clinical side effects resulting from its use.
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36
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Abstract
The hands, just like the face, are highly visible parts of the body. They age at a similar rate and demonstrate comparable changes with time, sun damage, and smoking. Loss of volume in the hands exposes underlying tendons, veins, and bony prominences. Rejuvenation of the hands with dermal fillers is a procedure with high patient satisfaction and relatively low risk for complications. This study will review relevant anatomy, injection technique, clinical safety, and efficacy of dermal filler volumization of the aging hand.
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37
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Kruglikov IL, Wollina U. Soft tissue fillers as non-specific modulators of adipogenesis: change of the paradigm? Exp Dermatol 2015; 24:912-5. [PMID: 26309229 DOI: 10.1111/exd.12852] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2015] [Indexed: 12/15/2022]
Abstract
Dermal filler injection is a cornerstone of facial rejuvenation procedures. Based on available data in animal and human studies, we suppose that the activation and proliferation of adipose-derived stem cells and expansion of mature adipocytes play a crucial role in long-term effects of volumizing, tissue tightening and beautification.
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Affiliation(s)
| | - Uwe Wollina
- Hospital Dresden-Friedrichstadt, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
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