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Casabona G, Frank K, Zeng R, Cotofana S, Alfertshofer M, Weinmann C, Moellhoff N, Kaye KO. Investigating Facial Muscle Physiology Following Soft Tissue Filler Injections-A Surface-derived Electromyographic and Skin Vector Displacement Analytic Study. Facial Plast Surg 2024. [PMID: 38834176 DOI: 10.1055/a-2338-0581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
The use of hyaluronic acid-based soft tissue fillers has often been reported to modulate the muscle, that is, to cause myomodulation. To our knowledge, there has been so far no scientific study investigating the potential of hyaluronic acid-based soft tissue fillers to modulate or actually alter the function of facial muscles. To further assess this three-dimensional (3D) surface imaging and electromyography (EMG)-based prospective study investigated the changes of facial muscle contraction after injection of strategically placed hyaluronic acid-based soft tissue fillers to assess the actual validity of the term myomodulation. A total of 13 subjects with a mean age of 37.8 years (12 females, 1 male) were injected according to a predefined injection protocol. Surface EMG and 3D surface imaging were performed prior to the injection and 5 days after the injection. The results showed no significant change in the strength of the muscles (measured in μV) after injection of hyaluronic acid-based soft tissue fillers. However, horizontal and vertical skin displacement upon contraction of the zygomaticus major muscle changed significantly between baseline and follow-up, with a mean horizontal skin displacement increase from 3.2 to 4.1 mm. Upon contraction of the depressor anguli oris muscle, the horizontal skin displacement did not change significantly (2.15 vs. 2.05 mm), while vertical skin displacement increased significantly from 2.9 to 4.3 mm. The modification of the surrounding tissue caused an alteration of the vectorial skin displacement upon contraction of the muscle. A potential explanation could be the increased distance between the origin and insertion of the muscle due to the material deposition in the proximity of the relevant facial muscles, leading to a change of contraction vector.
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Affiliation(s)
- Gabriela Casabona
- Department of Plastic Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain
| | - Konstantin Frank
- Department of Plastic Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain
| | - Rui Zeng
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University, Munich, Germany
| | - Sebastian Cotofana
- Department of Dermatology, Erasmus Hospital, Rotterdam, The Netherlands
- Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Michael Alfertshofer
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University, Munich, Germany
| | - Charlotte Weinmann
- Klinik für Plastische, Ästhetische, Hand und Wiederherstellungschirurgie des Universitären Medizincampus Niederbayern, Passau, Germany
| | - Nicholas Moellhoff
- Department for Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilian University, Munich, Germany
| | - Kai O Kaye
- Department of Plastic Aesthetic Surgery, Ocean Clinic Marbella, Marbella, Spain
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2
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Chen Q, Wang Y. Ellansé: Advanced Technology and Advantageous Selection of New Collagen Stimulating Agents for Face Rejuvenation. Aesthetic Plast Surg 2024; 48:1977-1984. [PMID: 38305923 DOI: 10.1007/s00266-023-03761-w] [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: 09/10/2023] [Accepted: 11/14/2023] [Indexed: 02/03/2024]
Abstract
Facial injections have a comparative mature market and system in China, but all kinds of injection materials have their own advantages and disadvantages, even hyaluronic acid, as the most common injection material, can form an unnatural stiffness after injection. Currently, Ellansé, a biodegradable collagen stimulator, has shown superior aesthetic results while ensuring safety and naturalness, making it a more preferable choice for a variety of facial injections. The purpose of this review is to introduce the features and benefits of Ellansé, so that doctors in the field can better understand and learn how to use it properly and minimize the risk of complications, and have a better choice for the medical aesthetic field in China in numerous aspects. The papers with the keyword "Ellansé" is very few in number, and there is a lack of systematic overview. Ellansé itself has unique advantages for the Chinese population, as it is an attractive option for the treatment of aging face due to high patient satisfaction, long-lasting results and low side effects (Guo et al. in J Cosmet Dermatol 21(5):1959-1966, 2022). More clinical data will be available in the future to confirm its performance and longevity in various sites. LEVEL OF EVIDENCE V: 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)
- Qiyue Chen
- Wenzhou Medical University, Wenzhou, China
| | - Yongshu Wang
- Wenzhou Medical University, Wenzhou, China.
- Nanjing Victoria Plastic Surgery Hospital, Nanjing, China.
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3
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Barbosa ADP, Espasandin I, Pinheiro de Lima L, de Souza Ribeiro C, Raquel Silva L, Faria Quintal T, Nascimento Lima E, Catarina Duarte Vieira L, Soares TR, Autran Colaço AR. Body Harmonization: The Definition of a New Concept. Clin Cosmet Investig Dermatol 2023; 16:3753-3766. [PMID: 38170132 PMCID: PMC10759920 DOI: 10.2147/ccid.s426813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/05/2023] [Indexed: 01/05/2024]
Abstract
Body Harmonization (BHA) is an innovative concept in aesthetics area based on a set of advanced injectable techniques that have shown promising results for body shaping. This is based on procedure combinations indicated to treat body aesthetic dysfunctions, such as localized fat, stretch marks, blemishes, flaccidity, buttocks remodeling, lean mass gain and muscle definition. This study aims to define the clinical concept of BHA, its applications and the main protocols used based on injectable pharmacotherapy. For this purpose, we performed a retrospective review of proven efficient injectable procedures with advanced results for the treatment of body aesthetic disorders, in addition to relying on data obtained from previous clinical experiences. Based on these data, we describe how different compounds can act for treatment of the main body aesthetic dysfunctions, such as lipolytic compounds and collagen biostimulators. In addition, the main application techniques and treatment protocols for each of these dysfunctions were defined. Minimally invasive injectable procedures offer an effective therapeutic option for patients who do not intend to undergo surgical interventions.
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Affiliation(s)
- Antony de Paula Barbosa
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Isabela Espasandin
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Lucas Pinheiro de Lima
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Caroline de Souza Ribeiro
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Lara Raquel Silva
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Thalita Faria Quintal
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Evenny Nascimento Lima
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Láila Catarina Duarte Vieira
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Thaina Ribeiro Soares
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
| | - Anna Raphaella Autran Colaço
- Department of Research & Development, Health & Aesthetics, Antony Barbosa Institute, Belo Horizonte, MG, 30575-210Brazil
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Cohen JL, Goodman GJ, De Almeida AT, Jones D, Carruthers J, Grimes PE, de Maio M, Swift A, Solish N, Fagien S, Carruthers A, Sangha S. Decades of beauty: Achieving aesthetic goals throughout the lifespan. J Cosmet Dermatol 2023; 22:2889-2901. [PMID: 37632289 DOI: 10.1111/jocd.15968] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Several elements, including age, influence judgments of beauty and attractiveness. Aging is affected by intrinsic factors (e.g., genetics, race/ethnicity, anatomical variations) and extrinsic factors (e.g., lifestyle, environment). AIMS To provide a general overview of minimally invasive injectable procedures for facial beautification and rejuvenation to meet the aesthetic goals of patients across their lifespan, organized by decade. METHODS This case study review describes aesthetic considerations of females in their third to sixth decade of life (i.e., 20-60 years of age or beyond). Each case study reports the treatments, specifically botulinum toxin type A and soft tissue fillers, used to address aesthetic concerns. RESULTS Signs of aging, as well as aesthetic goals and motivations, vary by age groups, cultures, and races/ethnicities. However, there are overarching themes that are associated with each decade of life, such as changes in overall facial shape and specific facial regions, which can be used as a starting point for aesthetic treatment planning. Appropriate patient selection, thorough aesthetic evaluation, product knowledge, and injection technique, as well as good physician-patient communication, are essential for optimal treatment outcomes. CONCLUSIONS Nonsurgical facial injectable treatments can successfully enhance and rejuvenate facial features across different age ranges. A comprehensive understanding of facial aging and the aesthetic considerations of patients by the decade contributes to optimal treatment planning and maintenance.
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Affiliation(s)
- Joel L Cohen
- AboutSkin Dermatology and DermSurgery, Greenwood Village, Colorado, USA
| | - Greg J Goodman
- Adjunct Professor of Dermatology, Monash University, Clayton, Victoria, Australia
| | - Ada Trindade De Almeida
- Medical Director and Cosmetic Dermatologic Surgeon, Clinica de Dermatologia, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Derek Jones
- Skin Care and Laser Physicians of Beverly Hills, Los Angeles, California, USA
| | - Jean Carruthers
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Pearl E Grimes
- Vitiligo & Pigmentation Institute, Los Angeles, California, USA
| | | | - Arthur Swift
- Westmount Institute of Plastic Surgery, Montreal, Quebec, Canada
| | | | - Steven Fagien
- Aesthetic Eyelid Plastic Surgery, Boca Raton, Florida, USA
| | | | - Sara Sangha
- Allergan Aesthetics, an AbbVie Company, Irvine, California, USA
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Angelo-Khattar M. Objective Assessment of the Long-Term Volumizing Action of a Polycaprolactone-Based Filler. Clin Cosmet Investig Dermatol 2022; 15:2895-2901. [PMID: 36597519 PMCID: PMC9805706 DOI: 10.2147/ccid.s385202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/30/2022] [Indexed: 12/29/2022]
Abstract
Background The polycaprolactone-based filler, (PCL-1, Ellansé-S), forms part of the recently growing portfolio of biodegradable collagen-stimulating fillers. It is comprised of a suspension of 25-50 micron diameter microspheres of polycaprolactone (PCL) (30%) in a carboxymethyl cellulose (CMC) gel carrier (70%) and has gained popularity due to its long-term volumizing action. Objective This study outlines a retrospective case series of nine patients injected with the PCL-1, for volume augmentation in the mid-face. Objective volume calculations were performed with the Canfield Vectra 3D Imaging System at two time points post-implantation, with the objective of determining the longevity of the volumizing effect of the bio-stimulating substance. Results A clear increase in volume, between 50-150%, was found in all of the patients at two years, over and above the volume initially injected. All the patients were satisfied with the longevity of the results. Discussion The PCL-based filler is believed to afford immediate volume restoration due to the CMC gel component and a long-term action due to neo-collagenesis, induced by the PCL microspheres. The CMC gel is known to dissipate within 6-8 weeks, only to be replaced by new collagen induced by the PCL particles. Thus soft-tissue formation induced by the PCL particles, ultimately leads to a sustained volumizing effect. Conclusion The PCL-based filler is shown to have a sustained volumizing effects of at least 2 years duration with clear evidence of increase in volume over and above the volume injected, in all of the cases studied. This is indicative of significant neo-collagenesis induced by the PCL microspheres.
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Affiliation(s)
- Maria Angelo-Khattar
- American Academy of Anti-aging Medicine, Dubai, United Arab Emirates,Altaderma Clinic, Dubai, United Arab Emirates,Correspondence: Maria Angelo-Khattar, Tel +971506245494, Email
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Zhao H, Ren R, Bao S, Qian W, Ma X, Wang R, Li X, Fang R, Sun Q, Tian Y, Zhu C, Shi J. Efficacy and Safety of Polycaprolactone in Treating Nasolabial Folds: A Prospective, Multicenter, and Randomized Controlled Trial. Facial Plast Surg 2022; 39:300-306. [PMID: 36191597 PMCID: PMC10171959 DOI: 10.1055/a-1954-3986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Nasolabial folds (NLFs) are the most pronounced sign of facial aging. This study explored the efficacy and safety of polycaprolactone gel in treating Chinese patients with moderate-to-severe NLFs. Patients with moderate-to-severe NLF who wished to be treated by dermal fillers were recruited from three centers between July 2017 and September 2019. The randomizing ratio was 1:1 in the polycaprolactone group (polycaprolactone injection) or control group (sodium hyaluronate gel injection). The primary endpoint was the effectiveness rate of Wrinkle Severity Rating Score (WSRS) scores at 12 months after injection. The full-analysis set (FAS) and safety sets had 80 patients in the polycaprolactone group and control group, respectively. In the FAS, the effectiveness rate at 12 months in the polycaprolactone group was 88.8% compared with 23.8% in controls (P < 0.001). The improvement in WSRS sustained during 12 months in the polycaprolactone group, while gradually vanished in the control group since 3 months after surgery. The global aesthetic improvement scale (GAIS) by investigator assessments was improved, much improved, or very much improved in all patients during follow-up, while the proportion of patients with a "no change" assessment gradually increased during follow-up after 6 months in the control group. The rates of injection-related adverse event (AE) and serve injection-related AE were 8.8 versus 11.3% and 0 versus 1.3% in the polycaprolactone group and control groups, respectively. Polycaprolactone gel injection is effective and safe to treat moderate-to-severe NLFs in Chinese patients.
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Affiliation(s)
- Hongyi Zhao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Rongxin Ren
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shiwei Bao
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wenjiang Qian
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xiaobing Ma
- Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Ruiyan Wang
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Xiaoxin Li
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Rouyu Fang
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Beijing, People's Republic of China
| | - Yan Tian
- Department of Dermatology, Air Force Characteristic Medical Center, Beijing, People's Republic of China
| | - Chaonan Zhu
- Huadong Medical Co. Ltd, Hangzhou, People's Republic of China
| | - Jianling Shi
- Huadong Medical Co. Ltd, Hangzhou, People's Republic of China
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7
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Christen MO. Collagen Stimulators in Body Applications: A Review Focused on Poly-L-Lactic Acid (PLLA). Clin Cosmet Investig Dermatol 2022; 15:997-1019. [PMID: 35761856 PMCID: PMC9233565 DOI: 10.2147/ccid.s359813] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/18/2022] [Indexed: 11/25/2022]
Abstract
The number of aesthetic procedures performed worldwide continues to grow together with an increase in the population seeking the restoration or preservation of a youthful appearance. Requests for non-surgical body rejuvenation are increasing. Patients are looking for safe and effective minimally invasive aesthetic procedures. Soft-tissue dermal fillers can meet these expectations. Based on the beneficial outcomes of these treatments in many facial areas, a new trend is developing to target body areas. Different dermal fillers are available and include collagen stimulators initially developed to restore facial volume. Furthermore, they are associated with long-lasting efficiency, a high level of patient satisfaction and a good safety profile, with mainly minor adverse events reported. In appropriate conditions of use, they are now used for body rejuvenation in clinical practice. Their use is expanding and allows addressing various issues including volume loss, skin laxity, cellulite, striae distensae and wrinkles. This review focuses on poly-L-lactic acid (PLLA), used in the first collagen stimulator and one of the most investigated in facial and in off-facial body applications. The available published data, although still limited, are presented by body area, neck and chest, buttocks, abdomen, upper arms, thighs, knees, and hands. Key features of the concerned zones and the main clinical signs affecting the body part as well as the injection modalities are provided along with the aesthetic results. This represents the state of the art on which to base further developments necessary for optimal and safe outcomes of treatment with the PLLA-based collagen stimulators and others in this class for body rejuvenation.
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8
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Park JW, Choi SY, Kim KR, Jin M, Seok J, Yoo KH, Kim BJ. A randomized, participant-and evaluator-blinded, matched-pair prospective study to compare the safety and efficacy between polycaprolactone-based fillers in the correction of nasolabial folds. Dermatol Ther 2022; 35:e15508. [PMID: 35419911 DOI: 10.1111/dth.15508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Polycaprolactone (PCL)-based fillers are widely used for skin rejuvenation and wrinkle reduction. OBJECTIVE To compare the efficacy and safety of newly developed PCL-based fillers (SYB filler®; SF-01) and widely used existing PCL-based fillers (Ellansé-M®) for correction of moderate-to-severe nasolabial folds. METHODS In a randomized, participant-and evaluator-blinded, matched-pair, prospective study, participants were randomized for injections of SF-01 or Ellansé-M® in both nasolabial folds. Efficacy was evaluated using the Wrinkle Severity Rating Scale (WSRS), Global Esthetic Improvement Scale (GAIS), and a 3-dimensional (3D) scanner. All adverse events (AEs) were examined and reported. RESULTS At month 12, both SF-01-and Ellansé-M®-treated groups showed statistically significant improvements in the WSRS, GAIS, and 3D scanner scores compared to baseline. The difference in changes in WSRS scores at month 12 between the two groups was 0.08 ± 0.34 compared to baseline. The upper limit of the 95.0% confidence interval was 0.0031, which was lower than the predefined margin for non-inferiority (0.35). All AEs were injection site-related (swelling, pain, and erythema) and disappeared within 30 min after the procedure. CONCLUSION SF-01 was non-inferior to Ellansé-M® and demonstrated favorable efficacy and safety at 12 months after correcting moderate-to-severe nasolabial folds.
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Affiliation(s)
- Jae Wan Park
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sun Young Choi
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Ka Ram Kim
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Miryung Jin
- Samyang Holdings Corp, Clinical & Regulatory Affairs Team, Gyeonggi, Republic of Korea
| | - Joon Seok
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Kwang Ho Yoo
- Department of Dermatology, Chung-Ang University Gwang-Myeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, Gyeonggi-do, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
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9
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Ilyas RA, Zuhri MYM, Norrrahim MNF, Misenan MSM, Jenol MA, Samsudin SA, Nurazzi NM, Asyraf MRM, Supian ABM, Bangar SP, Nadlene R, Sharma S, Omran AAB. Natural Fiber-Reinforced Polycaprolactone Green and Hybrid Biocomposites for Various Advanced Applications. Polymers (Basel) 2022; 14:182. [PMID: 35012203 PMCID: PMC8747341 DOI: 10.3390/polym14010182] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/30/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
Abstract
Recent developments within the topic of biomaterials has taken hold of researchers due to the mounting concern of current environmental pollution as well as scarcity resources. Amongst all compatible biomaterials, polycaprolactone (PCL) is deemed to be a great potential biomaterial, especially to the tissue engineering sector, due to its advantages, including its biocompatibility and low bioactivity exhibition. The commercialization of PCL is deemed as infant technology despite of all its advantages. This contributed to the disadvantages of PCL, including expensive, toxic, and complex. Therefore, the shift towards the utilization of PCL as an alternative biomaterial in the development of biocomposites has been exponentially increased in recent years. PCL-based biocomposites are unique and versatile technology equipped with several importance features. In addition, the understanding on the properties of PCL and its blend is vital as it is influenced by the application of biocomposites. The superior characteristics of PCL-based green and hybrid biocomposites has expanded their applications, such as in the biomedical field, as well as in tissue engineering and medical implants. Thus, this review is aimed to critically discuss the characteristics of PCL-based biocomposites, which cover each mechanical and thermal properties and their importance towards several applications. The emergence of nanomaterials as reinforcement agent in PCL-based biocomposites was also a tackled issue within this review. On the whole, recent developments of PCL as a potential biomaterial in recent applications is reviewed.
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Affiliation(s)
- R. A. Ilyas
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia (UTM), Johor Bahru 81310, Johor, Malaysia;
- Centre for Advanced Composite Materials (CACM), Universiti Teknologi Malaysia (UTM), Johor Bahru 81310, Johor, Malaysia
| | - M. Y. M. Zuhri
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia;
- Advanced Engineering Materials and Composites Research Centre (AEMC), Department of Mechanical and Manufacturing Engineering, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor, Malaysia
| | - Mohd Nor Faiz Norrrahim
- Research Center for Chemical Defence, Universiti Pertahanan Nasional Malaysia, Kem Sungai Besi, Kuala Lumpur 57000, Malaysia;
| | - Muhammad Syukri Mohamad Misenan
- Department of Chemistry, College of Arts and Science, Davutpasa Campus, Yildiz Technical University, Esenler, Istanbul 34220, Turkey;
| | - Mohd Azwan Jenol
- Department of Bioprocess Technology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor, Malaysia;
| | - Sani Amril Samsudin
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia (UTM), Johor Bahru 81310, Johor, Malaysia;
| | - N. M. Nurazzi
- Centre for Defence Foundation Studies, Universiti Pertahanan Nasional Malaysia (UPNM), Kem Perdana Sungai Besi, Kuala Lumpur 57000, Malaysia;
| | - M. R. M. Asyraf
- Institute of Energy Infrastructure, Universiti Tenaga Nasional, Jalan IKRAM-UNITEN, Kajang 43000, Selangor, Malaysia;
| | - A. B. M. Supian
- Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia;
| | - Sneh Punia Bangar
- Department of Food, Nutrition and Packaging Sciences, Clemson University, Clemson, SC 29631, USA;
| | - R. Nadlene
- Fakulti Kejuruteraan Mekanikal, Universiti Teknikal Malaysia Melaka, Melaka 76100, Malaysia;
| | - Shubham Sharma
- Department of Mechanical Engineering, IK Gujral Punjab Technical University, Jalandhar 144001, India;
| | - Abdoulhdi A. Borhana Omran
- Department of Mechanical Engineering, College of Engineering, Universiti Tenaga Nasional, Jalan Ikram-Uniten, Kajang 43000, Selangor, Malaysia;
- Department of Mechanical Engineering, College of Engineering Science & Technology, Sebha University, Sabha 00218, Libya
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10
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Heo Y, Shin SW, Kim DS, Lee S, Park SY, Baek SW, Lee JK, Kim JH, Han DK. Bioactive PCL microspheres with enhanced biocompatibility and collagen production for functional hyaluronic acid dermal fillers. Biomater Sci 2022; 10:947-959. [DOI: 10.1039/d1bm01846a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Polymeric microspheres containing magnesium hydroxide (MH) and a bioactive agent (BA), such as apocynin (APO) and astaxanthin (ATX), have been prepared as functional dermal fillers with enhanced physicochemical and biological performance.
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Affiliation(s)
- Yun Heo
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
| | - Sang-Woo Shin
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
| | - Da-Seul Kim
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
- School of Integrative Engineering, Chung-Ang University, Dongjak-gu, Seoul 06911, Republic of Korea
| | - Semi Lee
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
| | - So-Yeon Park
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
- Division of Biotechnology, College of Life Sciences and Biotechnology, Korea University, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Seung-Woon Baek
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
- Department of Biomedical Engineering, SKKU Institute for Convergence, Sungkyunkwan University (SKKU), Suwon-si, Gyeonggi 16419, Republic of Korea
- Department of Intelligent Precision Healthcare Convergence, SKKU Institute for Convergence, Sungkyunkwan University (SKKU), Suwon-si, Gyeonggi 16419, Republic of Korea
| | - Jun-Kyu Lee
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
| | - Jun Hyuk Kim
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
| | - Dong Keun Han
- Department of Biomedical Science, CHA University, Seongnam-si, Gyeonggi 13488, Republic of Korea
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11
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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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12
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Moers-Carpi M, Christen MO, Delmar H, Brun P, Bodokh I, Kestemont P. European Multicenter Prospective Study Evaluating Long-Term Safety and Efficacy of the Polycaprolactone-Based Dermal Filler in Nasolabial Fold Correction. Dermatol Surg 2021; 47:960-965. [PMID: 33731572 DOI: 10.1097/dss.0000000000002978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Age-related changes affecting facial areas can be corrected using minimally invasive dermal fillers. The use of polycaprolactone-dermal filler (PCL-filler) in aesthetics is increasing. OBJECTIVE To evaluate the long-term safety and efficacy of the PCL-filler, in a European, multicenter, prospective study. MATERIALS AND METHODS Subjects (n = 90) with moderate/severe nasolabial folds (Wrinkle Severity Rating Scale [WSRS]: 3 to 4) were treated on Day 0 with a single injection of similar volume on each side; safety and efficacy assessments were performed over an 18-month period. In 1 of the 3 study centers, safety was evaluated at 30 months. RESULTS At Month 12 (M12; primary endpoint), 84% of subjects showed a ≥1-point improvement on the WSRS (M6: 92%; M18: 64%). From the investigator/subject's evaluation, from Day 7 to M12, Global Aesthetic Improvement was reported for >90% of subjects, with the effect maintained for up to 18 months in >80% of patients. Subjects/investigators reported high satisfaction and skin quality improvement. Most of the immediate injection-site reactions disappeared after 2 to 4 days. No severe or unexpected adverse events were reported. CONCLUSION This study demonstrated the long-term safety and efficacy of the PCL-filler, with safety confirmed for up to 30 months.
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Affiliation(s)
| | | | - Henry Delmar
- Mediti-Clinique Science et Beauté, Juan-les-Pins, France
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13
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Chiang CH, Peng JH, Peng HLP. Filler-induced granuloma from polycaprolactone-based collagen stimulator injection in the tear trough area: A case report. J Cosmet Dermatol 2021; 20:1529-1531. [PMID: 33600081 DOI: 10.1111/jocd.14010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jui-Hui Peng
- Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Hsien-Li Peter Peng
- P-Skin Professional Clinic, Kaohsiung, Taiwan.,Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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14
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Zhao P, Zhao W, Zhang K, Lin H, Zhang X. Polymeric injectable fillers for cosmetology: Current status, future trends, and regulatory perspectives. J Appl Polym Sci 2020. [DOI: 10.1002/app.48515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Peng Zhao
- Center for Medical Device EvaluationNational Medical Products Administration Beijing 100081 People's Republic of China
| | - Wanlu Zhao
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Kai Zhang
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
- Institute of Regulatory Science for Medical DeviceSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Hai Lin
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
| | - Xingdong Zhang
- National Engineering Research Center for BiomaterialsSichuan University Chengdu Sichuan 610065 People's Republic of China
- Institute of Regulatory Science for Medical DeviceSichuan University Chengdu Sichuan 610065 People's Republic of China
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15
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Lin SL, Christen MO. Polycaprolactone-based dermal filler complications: A retrospective study of 1111 treatments. J Cosmet Dermatol 2020; 19:1907-1914. [PMID: 32485052 PMCID: PMC7497126 DOI: 10.1111/jocd.13518] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 02/02/2023]
Abstract
Background Aging signs can be corrected through volume restoration in multiple soft tissue layers and in the supraperiosteal plane using hyaluronic acid (HA) or nonhyaluronic acid (non‐HA) fillers. The non‐HA bioresorbable polycaprolactone (PCL)‐based filler with collagen‐stimulating properties has a proven safety profile, but rare potential complications such as nodules and granuloma can occur. Furthermore, PCL‐based fillers cannot be immediately removed by injection of an enzyme. These potential drawbacks have yet to be described in the literature. Aims The author performed 1111 treatments between 2015 and 2018. This study aims to review and analyze these treatments to ascertain the complication rates of the PCL‐based filler. Suggestions for complication prevention and management are also discussed. Methods 780 patients treated with the PCL‐based filler were reviewed by the physician between April 2015 and May 2018. During this period, 5595 syringes were used in 1111 treatments. All complication data were acquired by phone interviews, reports by patients, or observation at follow‐up visits. Complications were subdivided into early‐onset (occurring up to 2 weeks after treatment) and late‐onset events (occurring more than 2 weeks to years after treatment). Results Among the 1111 treatments, there were 50 cases (4.5%) of edema that lasted longer than 2 weeks, 30 cases (2.7%) of bruising, 8 cases (0.72%) of malar edema, 5 cases (0.45%) of temporarily palpable lumps and 2 cases (0.18%) of discoloration. There were no cases of intravascular injection, nodules/granulomas, or infection. Conclusion The complication rate of the PCL‐based filler was found to be low, and there were no cases of intravascular injection, nodules, and/or granulomas during the 3‐year observation. Longer‐lasting edema was associated with a higher injection volume and malar edema was related to lymphatic compression.
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Affiliation(s)
- Shang-Li Lin
- Shang-Li Dermatologic & Aesthetic Clinic, New Taipei City, Taiwan
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16
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de Melo F, Carrijo A, Hong K, Trumbic B, Vercesi F, Waldorf HA, Zenker S. Minimally Invasive Aesthetic Treatment of the Face and Neck Using Combinations of a PCL-Based Collagen Stimulator, PLLA/PLGA Suspension Sutures, and Cross-Linked Hyaluronic Acid. Clin Cosmet Investig Dermatol 2020; 13:333-344. [PMID: 32440186 PMCID: PMC7211299 DOI: 10.2147/ccid.s248280] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/09/2020] [Indexed: 12/31/2022]
Abstract
Background Combinations of minimally invasive procedures (MIPs) are often used in aesthetic treatments and are increasingly considered as the new standard of care. Three agents with specific properties are available in this perspective: a polycaprolactone (PCL)-based collagen stimulator, a poly-L-lactic acid (PLLA)- and a poly-glycolic acid (PLGA)-based resorbable suspension suture with a 3D-cone technology, and a cross-linked hyaluronic acid (HA). Objective To develop the first practice guidelines on rejuvenation treatment of the face and the neck using combinations of these agents, whether associated or not with other widely used MIPs such as botulinum neurotoxins or energy-based devices. Methods A multi-disciplinary, multi-national board of plastic surgeons and dermatologists convened to develop guidelines using a predefined consensus method. The consensus was defined as ≥83% agreement rate between participants. Results Practice guidelines and algorithms, describing optimal procedure sequence and spacing, are proposed for the treatment of upper-, mid-, lower-face and neck, combining the PCL collagen stimulator, the PLLA/PLGA suspension sutures, and the cross-linked HA, whether associated or not with other MIPs. Conclusion These new guidelines provide general support to optimal management strategies. Individual treatment plans should be adapted according to the physician’s individual competence and the patient’s preferences.
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17
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[Eruptive granuloma after injection of Ellansé® successfully treated using methotrexate]. Ann Dermatol Venereol 2020; 147:525-529. [PMID: 32276735 DOI: 10.1016/j.annder.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/21/2019] [Accepted: 02/28/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Collagen stimulators such as Ellansé® are soft tissue fillers able to induce nucleogenesis. We describe a case of eruptive foreign body granulomas following injection of Ellansé® that were successfully treated using methotrexate. CASE REPORT A 47-year-old woman received injections of Ellansé® for the wrinkled aspect of her cheeks. She had previously undergone injections of hyaluronic acid on the nasolabial folds. Nine months after the Ellansé® injections, the patient consulted for the recent appearance of multiple nodules on her face. Histological analysis of one of these nodules confirmed the presence of foreign-body granulomas developed in contact with spherical gaps of a size substantially identical to the Ellansé® vacuoles. Methotrexate 10mg per week for 3 months followed by 20mg per week for 9 months resulted in complete regression of the nodules. DISCUSSION Ellansé® is composed of two biocompatible and bioabsorbable polymers: carboxymethylcellulose, responsible for immediate volume creation, and polycaprolactone, which promotes collagen synthesis. However, any injected product can cause varying degrees of granulomatous reaction. Hyaluronic acid was previously injected at several other sites on the patient's face. These lesions were not the result of poor injection technique. CONCLUSION Although collagen stimulators are biocompatible and bioabsorbable substances, the development of foreign-body granulomas, while rare, is still possible. Methotrexate resulted in significant regression of nodules as of the third month of treatment.
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18
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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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19
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Christen MO, Vercesi F. Polycaprolactone: How a Well-Known and Futuristic Polymer Has Become an Innovative Collagen-Stimulator in Esthetics. Clin Cosmet Investig Dermatol 2020; 13:31-48. [PMID: 32161484 PMCID: PMC7065466 DOI: 10.2147/ccid.s229054] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/07/2019] [Indexed: 12/15/2022]
Abstract
Compared to other domains, tissue engineering and esthetics have dramatically expanded in recent years, leading to both major biomedical advances and futuristic perspectives. The two share a common approach based on biomaterials, especially polymers. This paper illustrates this with the example of polycaprolactone (PCL), a polymer synthesized in the early 1930s, and one of its most recent applications, a PCL-based collagen stimulator, a filler used in esthetics. PCL is biocompatible and biodegradable. Its specific physicochemical and mechanical properties, viscoelasticity and ease of shaping led to the production of PCL-based products with various shapes and durations dependent on its biodegradation kinetics. PCL has been safely used in the biomedical field for more than 70 years, from sutures to tissue and organ replacement by 3D printing. The PCL-based collagen stimulator is composed of PCL microspheres suspended in a carboxymethyl-cellulose gel carrier providing immediate and sustained volumizing effects when injected; the morphology, the biocompatibility of the PCL microspheres embedded with the collagen fibers produced all contribute to the creation of a unique 3D scaffold for a sustained effect. Its safety has been investigated in clinical studies and vigilance surveys. Recently published experts' recommendations on injection modalities and techniques should help further optimize treatment outcome and safety. This paper also integrates reviews and recommendations on the prevention and management of adverse events related to dermal and subdermal fillers including the PCL-based collagen stimulator. In addition, in terms of efficacy and safety, this product benefits from its daily clinical use in esthetics worldwide and continuous extensive fundamental and clinical research, both on it and the PCL polymer. Forthcoming data from further investigations will reinforce knowledge of the product and procedures in the field.
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20
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Shin SW, Jang YD, Ko KW, Kang EY, Han JH, Bedair TM, Kim IH, Son TI, Park W, Han DK. PCL microspheres containing magnesium hydroxide for dermal filler with enhanced physicochemical and biological performances. J IND ENG CHEM 2019. [DOI: 10.1016/j.jiec.2019.07.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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21
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Pourang A, Rockwell H, Karimi K. New Frontiers in Skin Rejuvenation, Including Stem Cells and Autologous Therapies. Facial Plast Surg Clin North Am 2019; 28:101-117. [PMID: 31779934 DOI: 10.1016/j.fsc.2019.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One of the greatest challenges in the progression of aesthetic medicine lies in providing treatments with long-term results that are also minimally invasive and safe. Keeping up with this demand are developments in autologous therapies such as adipose-derived stem cells, stromal vascular fraction, microfat, nanofat, and platelet therapies, which are being shown to deliver satisfactory results. Innovations in more traditional cosmetic therapies, such as botulinum toxin, fillers, and thread lifts, are even more at the forefront of the advancement in aesthetics. Combining autologous therapies with traditional noninvasive methods can ultimately provide patients with more effective rejuvenation options.
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Affiliation(s)
- Aunna Pourang
- Department of Dermatology, University of California, Davis, 3301 C Street, Suite 1400, Sacramento, CA 95816, USA
| | - Helena Rockwell
- University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Kian Karimi
- Rejuva Medical Aesthetics, 11645 Wilshire Boulevard #605, Los Angeles, CA 90025, USA.
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22
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Kim JS. Changes in Dermal Thickness in Biopsy Study of Histologic Findings After a Single Injection of Polycaprolactone-Based Filler into the Dermis. Aesthet Surg J 2019; 39:NP484-NP494. [PMID: 30778526 DOI: 10.1093/asj/sjz050] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During aging, facial skin thins, atrophies, and loses elasticity. Subdermal filler injections can volumize and treat wrinkles but cannot directly change dermal thickness. Polycaprolactone (PCL) fillers can improve skin texture and quality through dermal thickening and inducing neocollagenesis. Through biopsy study, evidence of neocollagenesis will be introduced. OBJECTIVES In this single-clinic prospective study, 13 patients received a single injection of diluted 0.5 cc of PCL filler in the facial dermis except the right temple area for intra-individual control study. METHODS A biopsy was performed from temple skin at 1 year for all patients. An additional biopsy was performed at 2 weeks and 4 years posttreatment for 3 patients. Dermal thickness was measured with sonography after 1 year. RESULTS On average, the mean rate of temporal skin thickness in biopsy specimens (n = 117 points in 13 patients) at 1 year posttreatment increased by 26.74% ± 9.26% from 1412.41 μm ± 69 μm to 1781.11 μm ± 110 μm (P < 0.001). On average, the mean thickness of facial skin (n = 39 points in 13 patients) measured by ultrasound at 1 year increased by 21.31% ± 4.34%. Around PCL particles, many fibroblasts, giant cells, new capillaries, new collagen, and elastic fibers were found in various stains. CONCLUSIONS Facial dermal thickness increased after intradermal injection of PCL filler by neocollagenesis to treat skin atrophy. PCL filler may last more than 4 years in the dermis. LEVEL OF EVIDENCE: 4
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23
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Lee SJ, Lee WS, Chung CH. Safety and efficacy of polycaprolactone copolymer nanosphere hydrogel injected into the scalp dermal tissue of rats. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2019. [DOI: 10.14730/aaps.2019.01739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Kwon TR, Han SW, Yeo IK, Kim JH, Kim JM, Hong JY, Lee BC, Lee SE, Moon HS, Kwon HJ, Kim BJ. Biostimulatory effects of polydioxanone, poly-d, l lactic acid, and polycaprolactone fillers in mouse model. J Cosmet Dermatol 2019; 18:1002-1008. [PMID: 30985064 DOI: 10.1111/jocd.12950] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/02/2019] [Accepted: 03/11/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Numerous fillers are increasingly used for augmentation of volume loss and relaxation of facial wrinkles. Collagen stimulators are the latest next-generation dermal fillers that can induce neocollagenesis. To investigate biophysical characteristics, safety, and efficacy of newly developed polydioxanone (PDO) filler in comparison with poly-l lactic acid (PLLA) and polycaprolactone (PCL) fillers. METHODS In vitro assay, morphology of particles, and rheological property of fillers were measured. A total of 24 female hairless mice (SKH1-Hrhr ) were randomly divided into three groups and injected with PDO, PLLA, or PCL fillers. Durability of fillers was assessed at 0, 3 days, and 1, 4, 8, 12 weeks after injection using folliscope and PRIMOS. To determine biocompatibility and neocollagenesis, histologic evaluation was performed at 1, 4, 8, and 12 weeks after injection. Efficacy was also evaluated based on skin surface roughness changes using PRIMOS in a hairless mouse photoaging model. RESULTS In the particle morphology test, PDO microspheres had an irregular surface and were spherical and uniformly sized. PDO filler demonstrated similar neocollagenesis and inflammatory response to other collagen stimulators. PDO filler showed better biodegradability than PLLA and PCL fillers. In the hairless mouse photoaging model, there was a statistically significant decrease in skin surface roughness after PDO filler injection. CONCLUSIONS Our data suggest that newly developed collagen stimulating PDO filler might be a safe and effective option for correction of volume loss and rejuvenation of photoaging skin.
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Affiliation(s)
- Tae-Rin Kwon
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Sung Won Han
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - In Kwon Yeo
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Jong Hwan Kim
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Jae Min Kim
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Ji-Yeon Hong
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
| | - Byung-Chul Lee
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Sung-Eun Lee
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | | | | | - Beom Joon Kim
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea.,Department of Medicine, Graduate School, Chung-Ang University, Seoul, Korea
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25
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Saretia S, Machatschek R, Schulz B, Lendlein A. Reversible 2D networks of oligo(
ε
-caprolactone) at the air–water interface. Biomed Mater 2019; 14:034103. [DOI: 10.1088/1748-605x/ab0cef] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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26
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Haneke E. Adverse effects of fillers. Dermatol Ther 2018; 32:e12676. [PMID: 30187592 DOI: 10.1111/dth.12676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 06/27/2018] [Accepted: 07/10/2018] [Indexed: 11/28/2022]
Abstract
Filler injections belong to the most frequently performed noninvasive beautifying procedures. When done correctly they are generally well tolerated. However, a number of factors, such as poor filler quality, and particularly host as well as user dependent filler reactions may lead to unwanted effects. These may be early, late, or delayed events with characteristics for each of them. Temporary fillers almost invariably cause temporary side effects whereas those of permanent fillers may last forever. Some fillers are notorious for their poor safety profile; for example, silicone is banned in the European Union and the United States but nevertheless used by many practitioners and beauticians. Many fillers can be identified in histopathologic sections allowing specific measures to be instituted.
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Affiliation(s)
- Eckart Haneke
- Dermatology Practice Dermaticum, Freiburg, Germany.,Department of Dermatology, Inselspital, Universitätsspital Bern, Bern, Switzerland.,Centro Dermatol Epidermis, Instituto CUF, Porto, Portugal.,Department of Dermatology, University Hospital, Ghent, Belgium
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27
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Skrzypek E, Górnicka B, Skrzypek DM, Krzysztof MR. Granuloma as a complication of polycaprolactone-based dermal filler injection: ultrasound and histopathology studies. J COSMET LASER THER 2018; 21:65-68. [PMID: 29757038 DOI: 10.1080/14764172.2018.1461229] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
In aesthetic medicine, there has been an ongoing search for an ideal dermal filler to offer zero complication rate. Polycaprolactone-based dermal filler (PCL) has been available since 2009. The purpose of the paper was to present a case of granuloma as a complication of PCL injection, which has not been reported so far by other researchers. A 68-year-old female was injected with PCL. One year later, nodules accompanied by bluish skin discoloration developed within the injection site. Ultrasound and histopathology studies were performed. The examinations confirmed the presence of foreign body granuloma after PCL, which makes it the first reported case worldwide. The published data analyses showed general lack of studies and case reports to address this issue. The PCL, like an injection of any soft tissue filler, may lead to serious complications, such as granuloma formation. This makes further research legitimate and necessary.
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Affiliation(s)
- Ewa Skrzypek
- a Department of History of Medicine , Medical University of Warsaw , Warsaw , Poland
| | - Barbara Górnicka
- b Department of Pathology , Medical University of Warsaw , Warsaw , Poland
| | | | - Mlosek Robert Krzysztof
- d Department of Diagnostic Imaging of the II Medical Faculty of the Medical University of Warsaw , Warsaw , Poland
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