ASDS Guidelines of Care: Injectable Fillers

Alam, Murad; Gladstone, Hayes B.; Kramer, Edward M.; Murphy, Jack P.; Nouri, Keyvan; Neuhaus, Isaac M.; Spencer, James M.; Spenceri, Elizabeth A.; Dyke, Susan Van; Ceilley, Roger I.; Lee, Ken K.; Menaker, Gregg M.; Monheit, Gary D.; Orentreich, David S.; Raab, Benjamin; Smith, Kevin; Solish, Nowell

doi:10.1111/j.1524-4725.2008.34253.x

Cited by 85 publications

(118 citation statements)

References 61 publications

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“…In addition to augmentation, this is achieved by using fillers to correct agerelated losses such as vertical rhytides, effacement of the lip margins and thinning of the lips [6,8,25,26]. It is the central unit of the upper lip, which consists of the dimple, with two columns of the tubercle, and the white roll between the two high edges of Cupid's bow [4][5][6][7] (Fig. 1).…”

Section: Introductionmentioning

confidence: 98%

“…Lip enhancement and augmentation procedures have become increasingly popular with some minimally invasive products for dermal filling and volume creation [20][21][22][23]. Candidates for lip enhancement include patients whose lips have flattened or lost volume, show vermilion and/or have lost definition due to aging, photodamage, smoking, or a combination of all, patients with congenitally thin and/or asymmetrical lips and patients who desire an enhanced lip shape or fullness [3,4,7].…”

Section: Introductionmentioning

confidence: 99%

“…They are one of the most attractive images of the face, achieving an aesthetic youthful and beautiful appearance [4,5]. The appearance including the shape, size, fullness and symmetry are important aspects of attractiveness [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation

et al. 2016

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Background Lip augmentation and changing contour lines have become more popular ways of improving the appearance. However, validated measures of lip fullness for quantification of outcomes are needed; ethnic background and personal goals can optimise outcomes while tailoring lip enhancement treatment to each individual's anatomy. The aim of this study is to analyse the morphological features of the lip in detail and to clarify the objective parameters in related with the subjective ones regarding the lip augmentation and lip reconstruction. Methods Standard photographs of the lips of 200 young Anatolian adults were calculated with linear and angular components. The features of the lower third of the face were analysed with the software program. Linear analyses (heights of the upper lip, the upper vermilion, the lower lip height, the lower vermillion and the chin height) and angular analyses (the upper lip, the lower lip, the apex and Cupid's bow angles) were measured as reference points. The lip shape was classified into five groups: thin, very thin, medium, full and very full. Results The lower third of the face was divided into three segments (Sn-Sto, Sm-Me and Sto-Sm), and the largest portion of the lower face was occupied by the chin and the smallest by the lower lip height in both genders. The upper vermilion height was 8.07 ± 1.8 mm in males and 7.08 ± 1.5 mm in females. The lower vermilion height was 10.1 ± 2.4 mm in males and 9.7 ± 1.9 mm in females. The upper lip angle was calculated as 30.3 ± 9.6°in males and 24.2 ± 6.2°mm in females. The lower lip angle was calculated as 38.3 ± 9.7°in males and 36.5 ± 6.4°in females. Meanwhile, the angular measurements of Cupid's bow (i.e., the apex and the central angle of Cupid's bow) were smaller in men than in women. When the lip was analyzed, the medium and full types in upper and lower lips accounted for substantial fractions in men, whereas medium and thin types were predominant also in women. Conclusions With the help of certain software, this research has made possible to define the best cosmetical redesign solution of lip construction and augmentation with a natural appearance for the patient. Level of Evidence: Level III, diagnostic study.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation

et al. 2016

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“…Following wellpublicised disasters after facial injection with paraffin derivatives in the early 20th century, it was not until 1962 that the use of silicone for cheek augmentation was described. [1][2][3] Since that time, a number of alternative materials have been developed and marketed and, most recently, hyaluronic acid (HA) fillers have massively increased their market share. The popularity of these HA-based fillers among patients and practitioners alike is probably due to their non-permanent nature and perceived improved safety profile, together with aggressive direct consumer marketing.…”

Section: Introductionmentioning

confidence: 99%

Complications of facial fillers: resource implications for NHS hospitals

Collier

Harach

Young

et al. 2012

British Journal of Oral and Maxillofacial Surgery

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SummaryFacial rejuvenation seeks to reverse the negative sequelae of multiple factors but most importantly of genetic predisposition, sun damage and smoking. With the advent of the so-called 'non-surgical' techniques, and perhaps fuelled by these austere times, volumetric facial augmentation using dermal fillers has soared in popularity among both patients and practitioners. However, legislation has yet to keep pace with the change in clinical practices leaving patients poorly informed and with no protection against unscrupulous suppliers and unregulated practitioners. When things go wrong, patients often turn to the National Health Service (NHS) to rectify both the acute and chronic sequelae resulting in potentially difficult ethical and resource implications. Here, we report one of an increasing number of cases presenting to our NHS craniofacial service with acute filler-related complications. BACKGROUND

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“…Due to its unique properties, including full biodegradability, biocompatibility, nontoxicity, high water absorption capacity, and nonimmunogenicity [3,4], this biopolymer is widely used for many medical applications. For example, HA is commonly used as an adjuvant for cataract surgery in ophthalmology [5], as a viscosupplement for the treatment of osteoarthritis in rheumatology [6] and for filling wrinkles and/or restoring facial volume in aesthetic medicine [1,7,8].…”

Section: Introductionmentioning

confidence: 99%

Influence of the Macro- and/or Microstructure of Cross-Linked Hyaluronic Acid Hydrogels on the Release of Two Model Drugs

Mondon¹,

Dadras²

2016

J Glycobiol

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Injectable hyaluronic acid (HA) hydrogels, crosslinked with 1,4-butanediol diglycidyl ether (BDDE), are widely used in aesthetic medicine. Due to their high clinical tolerance, HA hydrogels are thought to be applicable as injectable drug delivery systems. Here, HA matrix structures of BDDE-crosslinked HA hydrogels were analysed, and the effects of the structures on the release of two model drugs were assessed. Seven crosslinked HA hydrogels were observed by optical microscopy and cryo scanning electron microscopy (cryo-SEM). We observed three specific matrix macrostructures under optical microscopy: two had a "spider web"-like structure, three had a particulate structure, and two had an intermediate structure. These differences were less evident under cryo-SEM, where all hydrogels exhibited fibrous microstructures of different homogeneity levels, with pore sizes between 0.5 and 18 μm. Three cross-linked HA hydrogels with different macrostructures were loaded with bovine serum albumin (BSA) and lidocaine to assess their capacities to release drug over 4 days. No differences in drug release were observed between gels, and BSA was released for up to 4 days, which was four times longer than lidocaine. Thus, BDDEcrosslinked HA hydrogels could be applied as an injectable drug delivery system, particularly for the delivery of high-molecular-weight molecules.

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ASDS Guidelines of Care: Injectable Fillers

Cited by 85 publications

References 61 publications

Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation

Computer-assisted analysis contour lines of aesthetic unit for the assessment of lip augmentation

Complications of facial fillers: resource implications for NHS hospitals

Influence of the Macro- and/or Microstructure of Cross-Linked Hyaluronic Acid Hydrogels on the Release of Two Model Drugs

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