Tulsa Cosmetic Surgery » Facial Cosmetic Surgery

From Collagen to Fibroblasts: the Evolution of Dermal Fillers

Copyeditor — Fri, 09 Jul 2010 22:58:13 +0000

The last two years have seen a decrease in the use of collagen-based dermal fillers—and it shows in the announcements by two leading makers, Allergan and Johnson & Johnson, that they will no longer produce their respective collagen products (the human-derived CosmoDerm and CosmoPlast, the bovine Zyderm and Zyplast for Allergan; the porcine Evolence for Johnson & Johnson). For more than two decades, collagen has been the preferred filler for many cosmetic surgeons. Considering the origins of donor tissue, it is understandable that questions could arise. Plus, collagen-based fillers require skin allergy testing and are relatively short-lived compared to the next generation of fillers.

As in many markets, money drives the evolution of new products, and dermal fillers are no exception. The popularity of non-animal hyaluronic acid (HA) dermal fillers (known as replacement fillers because they replace lost volume) and PLLA and PMMA fillers (known as stimulatory fillers because they stimulate collagen and fibroblast production) has been strong in the recent past. Radiesse, Juvéderm, Perlane, Restylane, and Sculptra currently dominate the US market. Dermatologists report HA, PMMA, and PLLA fillers as being more versatile, longer-lasting, bulkier, and better for deep-volume filling than collagen.

But what about fine and thin line use, such as for foreheads or smokers lines around the mouth? Collagen was usually considered better for those applications. But Restylane Fine Lines is one HA product that makers hope to take over what used to be collagen territory.

What will the world of dermal fillers look like in the future? Change is certainly underway. Although fillers that indirectly stimulate fibroblast production are holding sway, direct injection of fibroblasts with Human Dermal Fibroblasts (HDFs) may be a trend. UK dermatologists are currently testing Valveta, a filler derived from the foreskins of male babies that is reputed to repopulate skin with healthy young cells and be long-lasting, if not permanent.

Otoplasty Study Measures Success of Different Sutures

newseditor — Tue, 01 Jun 2010 17:30:54 +0000

Otoplasty is a cosmetic surgery procedure that improves the proportion of the ears, often bringing them closer to the patient’s head. Cosmetic surgeons may use several techniques to accomplish this goal; each will typically involve an incision behind the ear and reshaping of the ear cartilage, followed by the placement of sutures to maintain the new ear shape.

Surgeons in Lithuania recently studied the success rate of different suture types used in Otoplasty. A 3-year study was conducted with 100 patients, who were divided into these groups based on the suture materials chosen:

PDS
Monocryl
Mersilene

Patients (48 men and 52 women) had a median age of 20 years. After analyzing the data for each group, the doctors found that 3 patients in the PDS group and 3 patients in the Monocryl group had unsatisfactory aesthetic outcomes requiring revision surgery. Patients in the Mersilene suture group had the lowest rate of recurrence.

Read more about this study online on PubMed: “Comparison of otoplasty outcomes using different types of suture materials”

newseditor — Mon, 19 Apr 2010 17:13:49 +0000

“It’s crucial to be very familiar with the anatomy of the upper third of the face before performing any surgery in that area.”

Dr. Cuzalina – recently featured in Cosmetic Surgery Times, discussing various aspects of facial anatomy and cosmetic procedures such as the endoscopic brow lift, lower eyelid surgery, facelift and cheek augmentation.

Link: Cosmetic Surgery Times

Surgeons Evaluate Use of Rib Cartilage in Rhinoplasty

newseditor — Mon, 18 Jan 2010 17:55:46 +0000

What surgeons call a “homologous costal cartilage graft” is tissue taken from a donor’s rib area, which can be used to augment the nose during rhinoplasty.

Is this the ideal implant substance for rhinoplasty? That’s a question some surgeons have sought to answer recently.

A study published late last year in Archives of Facial Plastic Surgery discussed the long-term results of this procedure and compared it to other common grafts used during nose surgery.

According to the authors, the ideal graft uses material meeting the following conditions:

Readily available in large quantities
Resists infection
Resists absorption
Completely integrated into host tissues
Causes little patient morbidity

Based on their research, rib cartilage taken from human donors appears to be a viable option for rhinoplasty and revision rhinoplasty. Analysis of long-term results indicated that patients who used these grafts experienced a low complication rate and high satisfaction (94.2 percent of the 357 patients said they were satisfied with the results).

Read more about this study at ScienceDaily.com or access the full article through Archives of Facial Plastic Surgery.

Healthy Patients Experience More Successful Surgery

newseditor — Mon, 29 Jun 2009 20:16:12 +0000

Trained cosmetic surgeons know that healthy patients – nonsmokers, at a stable body weight – have more successful surgery outcomes. That’s why they often decline to operate on patients who engage in unhealthy habits, due to the increased risks associated with such patients.

Those who are interested in cosmetic and facial cosmetic surgery should first go through a sort of ‘lifestyle makeover,’ modifying their habits until they have reached a satisfactory state of health. At Tulsa Cosmetic Surgery, we want our patients to have the best surgical experience possible, so we ask them to refrain from smoking, have a relatively stable weight, and keep realistic expectations about cosmetic surgery.