Polymethylmethacrylate filler complications, despite being rare, are often permanent and difficult or even impossible to treat. Safety guidelines should be observed when considering use of polymethylmethacrylate for augmentation.
The search for an ideal filler for soft tissue augmentation still continues. Because aging changes are continuous, temporary fillers should be preferred against permanent ones. Since 1999, the poly-L-lactic acid filler (PLA) has been marketed in Europe as Newfill. As a synthetic biocompatible polymer, PLA originally was used in suture materials and screws. In 2004, the U.S. Food and Drug Administration approved PLA under the name of Sculptra for the treatment of human immunodeficiency virus-related facial lipoatrophy. This study aimed to evaluate a 3-year follow-up investigation into the effect of PLA implant injection for the treatment of sunken nasolabial folds. Between October 2003 and February 2004, 10 women with a median age of 54 years (range, 43-60 years) were injected with polylactic acid hydrogel (Newfill) in the nasolabial fold area for aesthetic reasons. All the patients underwent three injections: one injection per month for 3 months. Evaluation of the results based on clinical examination and photography was performed at each session, at 6 months, and then 36 months after the third session. Injectable PLA was able to correct nasolabial folds successfully with a more lasting result than absorbable fillers commonly used in clinical practice, such as hyaluronic acid and collagen. Careful and standardized photographic documentation is indispensable.
SUMMARYThe lateral genicular artery flap is a fasciocutaneous flap used for knee reconstruction with low donor site morbidity.We performed an anatomical and hystomorphometrical study of the lateral genicular artery flap in eighteen fresh cadavers (thirty-six anatomical regions). Four clinical results of knee reconstruction are demonstrated.We found a constant vascular pedicle (100%), with intramuscular perforators in 40% of dissections. The perforator was situated at 7,40cm ± 2,77 above lateral condylle of the femur, between vastus lateralis muscle and the biceps femoris muscle. The pedicle measured 6,09 ± 1,91 cm of lenght from the popliteal artery.This flap was done and succeded in four patients.This flap showed constant anatomy and is reliable for coverage of defects at superior and lateral portions of the knee and the proximal part of the lower leg.
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