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Mechanisms of Foreign Body Giant Cell Formation in Response to Implantable Biomaterials. Polymers (Basel) 2023; 15:polym15051313. [PMID: 36904554 PMCID: PMC10007405 DOI: 10.3390/polym15051313] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
Long term function of implantable biomaterials are determined by their integration with the host's body. Immune reactions against these implants could impair the function and integration of the implants. Some biomaterial-based implants lead to macrophage fusion and the formation of multinucleated giant cells, also known as foreign body giant cells (FBGCs). FBGCs may compromise the biomaterial performance and may lead to implant rejection and adverse events in some cases. Despite their critical role in response to implants, there is a limited understanding of cellular and molecular mechanisms involved in forming FBGCs. Here, we focused on better understanding the steps and mechanisms triggering macrophage fusion and FBGCs formation, specifically in response to biomaterials. These steps included macrophage adhesion to the biomaterial surface, fusion competency, mechanosensing and mechanotransduction-mediated migration, and the final fusion. We also described some of the key biomarkers and biomolecules involved in these steps. Understanding these steps on a molecular level would lead to enhance biomaterials design and improve their function in the context of cell transplantation, tissue engineering, and drug delivery.
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Surgical Lip Remodeling Following Permanent Filler Injection: A Scoping Review. J Craniofac Surg 2021; 33:557-561. [PMID: 34260451 DOI: 10.1097/scs.0000000000007942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Over the years, several techniques have been introduced to obtain permanent lip enhancement, such as the use of silicone lip implants or the off-label use of permanent fillers. Although some reports indicate that permanent lip filler is safe, many others describe early- and late-onset complications. The main issue with permanent lip fillers is the lack of a standard technique to correct undesirable results. The aim of this scoping review was to list and evaluate the surgical pathways described in literature to correct lip deformity resulted from the injection of permanent fillers. The methods and the inclusion criteria of this work were specified in advance and documented in a protocol, according to the PRISMA 2009 checklist. The research was carried out on electronic databases PubMed, Cochrane Library, and Scopus databases identifying articles from March 1991 to December 2020 and conducted up to December 23rd, 2020. Articles language was limited to English. The selection process identified 3 retrospective studies eligible for inclusion. 73 patients and a total of 111 lips (72 upper and 39 lower) were considered. Two early complications were identified, 1 suture dehiscence and 1 total lip mucosa necrosis. Surgical lip remodeling following permanent filler injection seems to be an effective approach although the surgical pathway needs to be customized per each patient. Complication rate seems to be coherent to lip surgery performed with reconstructive purposes. To confirm these data case-control studies with much wider cohorts are needed to reach statistical significance.
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Jung JA, Kim KB, Park H, Dhong ES, Han SK, Kim WK. Subnasal Lip Lifting in Aging Upper Lip: Combined Operation with Nasal Tip Plasty in Asians. Plast Reconstr Surg 2019; 143:701-709. [PMID: 30589823 DOI: 10.1097/prs.0000000000005315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The objective of this study was to illustrate a novel technique for lifting of the aging upper lip with nasal tip plasty in Asians. With this procedure, a shortening of the philtrum, an increase of the vermilion, and a natural and nicer mouth can be obtained, with increase of the tip of the nose simultaneously. METHODS Thirty patients were the subjects of this study. Incisions were made bilaterally beginning at the alar fold, entering nostrils, and rising medially on the skin below the lower margin of the medial crura. Excess skin of the philtrum was eliminated in two separate pieces and the muscle was suspended to the base of the nose with interrupted stitches. RESULTS All patients expressed a high degree of satisfaction. The average ratio between the L1 reference line and the height of the upper lip measurement preoperatively was 0.43 ± 0.05. This ratio was improved postoperatively to an average of 0.32 ± 0.05. The nasolabial angle was 91.31 ± 4.19 degrees before surgery and 105.62 ± 5.04 degrees after surgery. The angle of the upper lip was 48.97 ± 2.41 degrees before surgery and 38.21 ± 3.34 degrees after surgery. CONCLUSIONS Lip lift is an effective tool for correcting a natural tendency of the upper lip to cover the upper teeth during aging. There is a dramatic improvement in the patient's facial aesthetic appearance during smiling and at rest. The authors strongly recommend this technique as part of the surgical procedure to achieve a youthful face. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Affiliation(s)
- Jae-A Jung
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
| | - Ki-Bum Kim
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
| | - Hyun Park
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
| | - Eun-Sang Dhong
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
| | - Seung-Kyu Han
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
| | - Woo-Kyung Kim
- From the Department of Plastic Surgery, Korea University College of Medicine; and the Park-Hyun Plastic Surgery Clinic
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Abtahi‐naeini B, Faghihi G, Shahmoradi Z, Saffaei A. Filler migration and extensive lesions after lip augmentation: Adverse effects of polydimethylsiloxane filler. J Cosmet Dermatol 2018; 17:996-999. [DOI: 10.1111/jocd.12476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Bahareh Abtahi‐naeini
- Skin diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan Iran
| | - Gita Faghihi
- Department of Dermatology Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan Iran
| | - Zabihollah Shahmoradi
- Department of Dermatology Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan Iran
| | - Ali Saffaei
- Department of Clinical Pharmacy School of Pharmacy and Pharmaceutical Sciences Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
- Pharmacy Students' Research Committee School of Pharmacy Isfahan University of Medical sciences Isfahan Iran
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Kandhari R, Goodman GJ, Signorini M, Rahman E. Use of a Hyaluronic Acid Soft-tissue Filler to Correct Congenital and Post-traumatic Lip Asymmetry. J Cutan Aesthet Surg 2017; 10:153-156. [PMID: 29403187 PMCID: PMC5782440 DOI: 10.4103/jcas.jcas_31_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: The use of hyaluronic acid soft-tissue fillers for enhancement of lip features is a popular and minimally invasive office-based procedure used worldwide due to its relative simplicity and favorable safety profile. Materials and Methods: Hyaluronic acid was used in illustrative cases to attempt correction of congenital and acquired lip asymmetries. Results: In the cases presented, accurate and cosmetically acceptable results were attained and maintained for the duration of the product life. Conclusions: Hyaluronic acid may be used successfully when lip asymmetry is evident and is a relatively simple nonsurgical alternative.
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Affiliation(s)
| | - Gregory J Goodman
- Monash University, Clayton, Australia.,Skin and Cancer Foundation Carlton, Victoria, Australia
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Systematic review of "filling" procedures for lip augmentation regarding types of material, outcomes and complications. J Craniomaxillofac Surg 2015; 43:883-906. [PMID: 25957105 DOI: 10.1016/j.jcms.2015.03.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/25/2015] [Accepted: 03/26/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The ideal lip augmentation technique provides the longest period of efficacy, lowest complication rate, and best aesthetic results. A myriad of techniques have been described for lip augmentation, but the optimal approach has not yet been established. This systematic review with meta-regression will focus on the various filling procedures for lip augmentation (FPLA), with the goal of determining the optimal approach. METHODS A systematic search for all English, French, Spanish, German, Italian, Portuguese and Dutch language studies involving FPLA was performed using these databases: Elsevier Science Direct, PubMed, Highwire Press, Springer Standard Collection, SAGE, DOAJ, Sweetswise, Free E-Journals, Ovid Lippincott Williams & Wilkins, Willey Online Library Journals, and Cochrane Plus. The reference section of every study selected through this database search was subsequently examined to identify additional relevant studies. RESULTS The database search yielded 29 studies. Nine more studies were retrieved from the reference sections of these 29 studies. The level of evidence ratings of these 38 studies were as follows: level Ib, four studies; level IIb, four studies; level IIIb, one study; and level IV, 29 studies. Ten studies were prospective. CONCLUSIONS This systematic review sought to highlight all the quality data currently available regarding FPLA. Because of the considerable diversity of procedures, no definitive comparisons or conclusions were possible. Additional prospective studies and clinical trials are required to more conclusively determine the most appropriate approach for this procedure. LEVEL OF EVIDENCE IV.
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Five-year Experience with Perma Facial Implant. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2014; 2:e153. [PMID: 25289346 PMCID: PMC4174082 DOI: 10.1097/gox.0000000000000091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 03/03/2014] [Indexed: 11/25/2022]
Abstract
SUMMARY Augmentation cheiloplasty is becoming an increasingly popular aesthetic procedure despite current methodologies having met with disappointment among surgeons and patients. The goal of this study was to examine the benefits and drawbacks of 1 device in particular-Perma Facial Implant (PFI). The senior authors (P.R. and S.W.H.) performed 832 consecutive PFI lip augmentations with excellent results based on photographic documentation, patient satisfaction surveys, unbiased surgeon ratings, and low complication rates. In addition to augmenting thin lips, PFIs hide excess dentition and improve vermilion rhytids and pout. Contrary to alternatives, they are both permanent and reversible. However, they do not level out asymmetries or benefit razor-thin lips without prior lifting or mucosal advancement.
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Abstract
Dermal filling has rapidly become one of the most common procedures performed by clinicians worldwide. The vast majority of treatments are successful and patient satisfaction is high. However, complications, both mild and severe, have been reported and result from injection of many different types of dermal fillers. In this Continuing Medical Education review article, the author describes common technical errors, the signs and symptoms of both common and rare complications, and management of sequelae in clear, easily adaptable treatment algorithms.
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Eversole R, Tran K, Hansen D, Campbell J. Lip augmentation dermal filler reactions, histopathologic features. Head Neck Pathol 2013; 7:241-9. [PMID: 23526034 PMCID: PMC3738755 DOI: 10.1007/s12105-013-0436-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 03/13/2013] [Indexed: 10/27/2022]
Abstract
Instances of perioral and labial foreign body reactions to a variety of injectable dermal fillers were selected from the oral and maxillofacial pathology and dermatopathology archives at Pacific Pathology Laboratory of San Diego with the objective being to engender a compilation of histopathologic characteristics that allow the pathologist to identify the inciting materials. All cases of foreign body reactions located in the lips and perioral regions were reviewed by four pathologists, retaining those cases with a history of injection lip augmentation as well as those with histologic features previously documented to represent dermal filler substances. In selected cases, Alcian blue pH 2.5 with and without hyaluronidase pretreatment was performed. Immunohistochemical markers for macrophages (CD 68), adipocytes (S-100) and keratinocytes (AE1/AE2) were undertaken. All instances presented as single or multiple submucosal plaques, nodules or swellings. Natural polymers including collagen, hyaluronate, hydroxyapatite, poly-L-lactate and synthetic polymers including carboxymethyl cellulose, dimethylpolysiloxane, and polyethyl methacrylate induce histologically unique features that allow for their identification. Host histopathologic responses included nodule without foreign body reaction, nodule with chronic inflammation, granuloma with epithelioid histiocytic and multinucleated giant cell reaction. Dermal filler foreign body host reactions in conjunction with the morphology of the foreign materials themselves are unique and can be differentiated from one another microscopically.
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Affiliation(s)
- Roy Eversole
- Oral Pathology Diagnostic Services, San Diego, CA 92123 USA
| | - Khahn Tran
- Pacific Pathology Laboratory, San Diego, CA 92123 USA
| | - Doyle Hansen
- Pacific Pathology Laboratory, San Diego, CA 92123 USA
| | - John Campbell
- Pacific Pathology Laboratory, San Diego, CA 92123 USA
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Moor EV, Olshinka A, Ad-El D. Surgical Technique for Remodelling Lip Deformities Due to Overinjection of Silicone Oil. Dermatol Surg 2012; 38:1049-53. [DOI: 10.1111/j.1524-4725.2012.02381.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Duffy DM. Commentary: Tacrolimus in the Treatment of Chronic and Refractory Late-Onset Immune-Mediated Adverse Effects Related to Silicone Injections. Dermatol Surg 2012; 38:48-50. [DOI: 10.1111/j.1524-4725.2011.02220.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sturm LP, Cooter RD, Mutimer KL, Graham JC, Maddern GJ. A systematic review of dermal fillers for age-related lines and wrinkles. ANZ J Surg 2011; 81:9-17. [PMID: 21299793 DOI: 10.1111/j.1445-2197.2010.05351.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dermal fillers are gaining popularity for rapid aesthetic improvement. Long-term efficacy and safety have not been well documented. The aim of this systematic review was to assess the safety and efficacy of injectable dermal fillers compared with other facial augmentation techniques for the management of age-related lines and wrinkles. METHODS Studies including patients receiving injectable semi-permanent or permanent dermal fillers for age-related lines and wrinkles were included in this review. Efficacy outcomes (including changes in skin thickness and patient satisfaction) and safety outcomes (including mortality, lumps and infections) were examined. RESULTS Three randomized control trials and six case series were included. Permanent and semi-permanent dermal fillers improved subjective ratings of appearance and resulted in higher patient satisfaction than temporary fillers. Long-term efficacy appeared good in the few studies that reported it. Short-term safety appeared favourable. Lumps were reported in all but one study but received little follow-up. Long-term safety data were limited. CONCLUSIONS The treatment of age-related lines and wrinkles with permanent and semi-permanent dermal fillers is more efficacious compared with temporary fillers in those studies that compared them. Case series evidence suggests that these fillers achieve their objective, which is to decrease the visible effects of age-related changes. These fillers appear at least as safe as temporary fillers in the short term in those studies that compared them. Long-term safety could not be determined.
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Affiliation(s)
- Lana P Sturm
- Royal Australasian College of Surgeons, Adelaide, SA, Australia
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Lemperle G, Anderson R, Knapp TR. An index for quantitative assessment of lip augmentation. Aesthet Surg J 2010; 30:301-10. [PMID: 20601553 DOI: 10.1177/1090820x10374095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lip dimensions and their relation to the whole face have been discussed mainly in the dental literature. There have been few attempts to scientifically measure the degree of lip augmentation, regardless of method. OBJECTIVES The authors describe a Lip Index that will allow reliable, quantitative analysis of the human lip complex, which is necessary to assess the efficacy and duration of attempts at lip augmentation. METHODS The authors developed a Lip Index as the basis for objective measurements of the effect and duration of lip augmentation with dermal fillers. Measurements may be taken directly from the patient, from standardized photos, or from the computer screen. Using a metric ruler, the height of the vermilion in the middle of the Cupid's bow is first measured (in mm) on the frontal view. The point of maximum protrusion of the vermilion is then measured (in mm) on a standardized side view perpendicular to a vertical line connecting the base of the columella to the fold demarcating lower lip and chin. Vermilion height multiplied by horizontal protrusion directly correlates with the central volume of the lips, upper and lower. RESULTS The easily applied ruler provided consistent measures before and after the injection of dermal fillers or soft implants. Adding upper and lower lip indices resulted in the Overall Lip Index for each patient, which was found to be approximately 50 in average females of Caucasian descent, about 100 in females of Asian descent, and nearly 200 in females of African descent. CONCLUSIONS The Lip Index allows for the practical evaluation of the clinical effects and duration of dermal filler injectables or implants. Quantitative assessments of results over time are easy to calculate, without the need for complex measurements or sophisticated analyses.
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Affiliation(s)
- Gottfried Lemperle
- Division of Plastic Surgery at the University of California, San Diego, CA, USA.
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15
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Penile Fournier Gangrene Caused by Liquid Silicone Injection. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2010. [DOI: 10.1097/ipc.0b013e3181b21a15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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HEVIA OSCAR. Six-Year Experience Using 1,000-Centistoke Silicone Oil in 916 Patients for Soft-Tissue Augmentation in a Private Practice Setting. Dermatol Surg 2009; 35 Suppl 2:1646-52. [DOI: 10.1111/j.1524-4725.2009.01343.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes. Plast Reconstr Surg 2009; 123:1842-1863. [DOI: 10.1097/prs.0b013e31818236d7] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Granulomatous foreign-body reaction involving oral and perioral tissues after injection of biomaterials: a series of 7 cases and review of the literature. J Oral Maxillofac Surg 2009; 67:280-5. [PMID: 19138600 DOI: 10.1016/j.joms.2008.01.052] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 01/04/2008] [Indexed: 11/23/2022]
Abstract
PURPOSE Injectable implants used for soft-tissue augmentation may lead to a granulomatous foreign-body reaction. The aim of this report is to present 7 new cases of foreign-body granulomas involving the oral and perioral tissues, after injection of biomaterials to achieve soft-tissue augmentation. In addition, the clinical and epidemiological profile of this condition is summarized, based on a review of the English-language literature of all previously described cases. PATIENTS AND METHODS We report on 7 new cases of granulomatous foreign-body reaction involving the oral and perioral tissues after the injection of biomaterials. A comprehensive literature review is also presented. RESULTS The literature search revealed 49 cases of this condition affecting the oral and perioral tissues. Our 7 patients were female, with a mean age of 52.8 years (range, 34 to 70 years). The lower lip was affected in 4 cases, 1 case was located in the upper lip, 1 case in the buccal mucosa, while 1 case involved 2 different sites (upper lip and buccal mucosa). Histopathologic examination revealed numerous cells with clear, often multiple, cytoplasmic vacuoles, bearing a resemblance to lipoblasts. Immunohistochemistry revealed diffuse positivity for the histiocytic marker CD68. CONCLUSIONS The diagnosis of granulomatous foreign-body reactions may be challenging because of their microscopic resemblance to liposarcoma, and because of the occasional reluctance of patients to report the previously performed esthetic procedure. A clinical history, histopathologic examination, and immunohistochemical analysis (as needed) are essential in achieving an accurate diagnosis.
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Weinand C, Murthy AS. Liquid silicone breast cosmesis—pros and cons of a conversely discussed material in a case report of silicone pneumonia in a transsexual male. EUROPEAN JOURNAL OF PLASTIC SURGERY 2008. [DOI: 10.1007/s00238-008-0310-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Chang DY, Jin HR. Foreign body inclusion cyst of the nasal radix after augmentation rhinoplasty. J Korean Med Sci 2008; 23:1109-12. [PMID: 19119460 PMCID: PMC2610650 DOI: 10.3346/jkms.2008.23.6.1109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 12/25/2007] [Indexed: 11/20/2022] Open
Abstract
Development of a cystic mass on the nasal dorsum is a very rare complication of aesthetic rhinoplasty. Most reported cases are of mucous cyst and entrapment of the nasal mucosa in the subcutaneous space due to traumatic surgical technique has been suggested as a presumptive pathogenesis. Here, we report a case of dorsal nasal cyst that had a different pathogenesis for cyst formation. A 58-yr-old woman developed a large cystic mass on the nasal radix 30 yr after augmentation rhinoplasty with silicone material. The mass was removed via a direct open approach and the pathology findings revealed a foreign body inclusion cyst associated with silicone. Successful nasal reconstruction was performed with autologous cartilages. Discussion and a brief review of the literature will be focused on the pathophysiology of and treatment options for a postrhinoplasty dorsal cyst.
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Affiliation(s)
- Dong-Yeop Chang
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Boramae Hospital, Seoul, Korea
| | - Hong-Ryul Jin
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Boramae Hospital, Seoul, Korea
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Schweiger ES, Riddle CC, Tonkovic-Capin V, Aires DJ. Successful treatment with injected hyaluronic acid in a patient with lip asymmetry after surgical correction of cleft lip. Dermatol Surg 2008; 34:717-9. [PMID: 18318726 DOI: 10.1111/j.1524-4725.2008.34133.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Surgical repair of cleft lip, while correcting deformity and dysfunction, may leave residual cosmetic imperfections. The resultant asymmetry and low volume of the upper lip can be addressed surgically and via less invasive methods. OBJECTIVE We present the first reported use of injectable hyaluronic acid to correct the characteristic lip asymmetry and poor volume after surgical repair of a cleft lip. METHODS AND MATERIALS Using injectable hyaluronic acid, we treated the patient's upper lip to restore symmetry and achieve an augmented volume. RESULTS We obtained a symmetric correction and aesthetically pleasing volume augmentation in the affected lip. These results lasted approximately 4 months. CONCLUSION Using a temporary, alloplastic, injectable soft tissue filler such as hyaluronic acid satisfactorily achieves correction of asymmetry and low volume in a surgically repaired cleft lip. For patients who have endured multiple corrective surgeries, this is a novel and less invasive way to improve their cosmetic concerns.
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Affiliation(s)
- Eric S Schweiger
- Division of Dermatology, University of Kansas Medical Center (KUMC), Kansas City, Kansas 66160, USA.
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Barnett JG, Barnett CR. Silicone Augmentation of the Lip. Facial Plast Surg Clin North Am 2007; 15:501-12, vii-viii. [DOI: 10.1016/j.fsc.2007.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW Facial aging results from multiple microscopic (histopathologic) and macroscopic (anatomic) changes. Whereas skin care and traditional surgery have much to offer patients desiring cosmetic improvement, they can fail to adequately address certain signs of facial aging. Soft-tissue augmentation with dermal fillers can successfully address these signs of aging by filling soft-tissue defects caused by age, scar formation, or disease. All dermal fillers aim to achieve the same goal: long-lasting soft-tissue augmentation without side effects. Each dermal filler preparation available for patient use has unique compositions and characteristics that impact its proper handling, therapeutic results, potential complications, and, ultimately, its ideal use. This review surveys the currently available preparations for soft-tissue augmentation. RECENT FINDINGS A review of the medical literature and manufacturers' information are included for dermal fillers currently approved for use by the US Food and Drug Administration. The composition, use, and potential limitation of each available preparation are reviewed. SUMMARY Dermal filling agents offer an excellent option for management of certain facial cosmetic changes. Since a wide range of products with significantly different characteristics is available, the treating physician should have sound knowledge of them all.
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Affiliation(s)
- Sukhjit S Johl
- Oculofacial Surgery, Department of Ophthalmology, The Permanente Medical Group, Inc., Sacramento, California 95815, USA.
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Narins RS, Beer K. Liquid Injectable Silicone: A Review of Its History, Immunology, Technical Considerations, Complications, and Potential. Plast Reconstr Surg 2006; 118:77S-84S. [PMID: 16936547 DOI: 10.1097/01.prs.0000234919.25096.67] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
For over five decades, liquid injectable silicone has been used for soft-tissue augmentation. Its use has engendered polarized reactions from the public and from physicians. Adherents of this product tout its inert chemical structure, ease of use, and low cost. Opponents of silicone cite the many reports of complications, including granulomas, pneumonitis, and disfiguring nodules that are usually the result of large-volume injection and/or industrial grade or adulterated material. Unfortunately, as recently as 2006, reports in The New England Journal of Medicine and The New York Times failed to distinguish between the use of medical grade silicone injected by physicians trained in the microdroplet technique and the use of large volumes of industrial grade products injected by unlicensed or unskilled practitioners. This review separates these two markedly different procedures. In addition, it provides an overview of the chemical structure of liquid injectable silicone, the immunology of silicone reactions within the body, treatment for cosmetic improvement including human immunodeficiency virus lipoatrophy, technical considerations for its injection, complications seen following injections, and some considerations of the future for silicone soft-tissue augmentation.
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Affiliation(s)
- Rhoda S Narins
- Dermatology Surgery and Laser Center, Department of Dermatology, New York University Medical School, White Plains 10604, USA.
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