14 December 2008
Breast Reduction
14/12/08 20:20 Filed in: Body Procedures
Breast reduction or reduction mammoplasty is an outpatient surgical procedure which involves the reduction in the size of breasts by excising fat, skin, and glandular tissue; it may also involve a procedure to counteract drooping of the breasts. As with breast augmentation, this procedure is typically performed on women, but may also be performed on men afflicted by gynecomastia.
The surgery, which the Food and Drug Administration has called "good medicine", is quickly gaining popularity. In 2005, over 113,000 women had breast reductions, an increase of 11 percent from 2004
Procedure
Doctors almost always perform breast reductions while the patient is under general anesthesia. During pre-operative visits, the doctor and patient may decide on new, usually higher, positions for the areolas and nipples.
For males, excess tissue may simply be removed through a tiny incision in each breast. This leaves minimal scarring.
Patients may take a few weeks for initial recovery, however it may take from six months to a year for the body to completely adjust to the new breast size. Some women may experience discomfort during their initial menstruation following the surgery due to the breasts swelling
Techniques
Inferior pedicle technique
The inferior pedicle technique, sometimes also known as a keyhole or Weiss pattern reduction, involves an anchor-shaped incision which circles the areola. The incision extends downward, following the natural curve of the breast. Excess glandular tissue, fat, and skin is removed. Next, the nipple and areola are moved into their new higher position. A drawback of this technique is sometimes "square" looking breasts, but this is a common option for women with the largest, droopiest breasts.
Vertical scar technique
The vertical scar technique, also known as the SPAIR or short scar breast reduction, is now widely gaining popularity due its minimal scarring and round shape post-surgery. To perform this, a doctor performs what is also known as a "lollipop incision" to the breast, resulting in the least amount of scarring. There are no horizontal incisions, and the scars are less likely to broaden with time, as with the Anchor-shaped technique. This technique keeps its results the best in the long term.The breast is reduced through removal of the lateral and inferior tissues, leaving the upper pole mostly untouched
Liposuction only technique
The liposuction only technique is used for women with breasts that are not quite as large as with the other procedures. For the best outcomes, women who choose this procedure have perkier breasts without a drooping nipple, as the skin itself never moves, but, rather, fat is simply removed from inside of the breast. The result is not as drastic as the other techniques, but it involves a much quicker healing time, less pain, and less money. This is the technique typically used for men.
Free nipple graft technique
The free nipple graft technique, a less common procedure, is now typically used only in the most extreme cases of drooping. In this procedure, the areola and nipple are completely removed for relocation and replaced as a skin graft higher on the breast. In these cases, sensation from the areola area will be lost and it is most likely to impair lactation as compared to the two most popular procedures, although some women have been known to successfully produce some amounts of milk.
The surgery, which the Food and Drug Administration has called "good medicine", is quickly gaining popularity. In 2005, over 113,000 women had breast reductions, an increase of 11 percent from 2004
Procedure
Doctors almost always perform breast reductions while the patient is under general anesthesia. During pre-operative visits, the doctor and patient may decide on new, usually higher, positions for the areolas and nipples.
For males, excess tissue may simply be removed through a tiny incision in each breast. This leaves minimal scarring.
Patients may take a few weeks for initial recovery, however it may take from six months to a year for the body to completely adjust to the new breast size. Some women may experience discomfort during their initial menstruation following the surgery due to the breasts swelling
Techniques
Inferior pedicle technique
The inferior pedicle technique, sometimes also known as a keyhole or Weiss pattern reduction, involves an anchor-shaped incision which circles the areola. The incision extends downward, following the natural curve of the breast. Excess glandular tissue, fat, and skin is removed. Next, the nipple and areola are moved into their new higher position. A drawback of this technique is sometimes "square" looking breasts, but this is a common option for women with the largest, droopiest breasts.
Vertical scar technique
The vertical scar technique, also known as the SPAIR or short scar breast reduction, is now widely gaining popularity due its minimal scarring and round shape post-surgery. To perform this, a doctor performs what is also known as a "lollipop incision" to the breast, resulting in the least amount of scarring. There are no horizontal incisions, and the scars are less likely to broaden with time, as with the Anchor-shaped technique. This technique keeps its results the best in the long term.The breast is reduced through removal of the lateral and inferior tissues, leaving the upper pole mostly untouched
Liposuction only technique
The liposuction only technique is used for women with breasts that are not quite as large as with the other procedures. For the best outcomes, women who choose this procedure have perkier breasts without a drooping nipple, as the skin itself never moves, but, rather, fat is simply removed from inside of the breast. The result is not as drastic as the other techniques, but it involves a much quicker healing time, less pain, and less money. This is the technique typically used for men.
Free nipple graft technique
The free nipple graft technique, a less common procedure, is now typically used only in the most extreme cases of drooping. In this procedure, the areola and nipple are completely removed for relocation and replaced as a skin graft higher on the breast. In these cases, sensation from the areola area will be lost and it is most likely to impair lactation as compared to the two most popular procedures, although some women have been known to successfully produce some amounts of milk.
Breast Lift
14/12/08 20:15 Filed in: Body Procedures
Breast Lift
Loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast-feeding ultimately affect the shape and firmness of your breasts. Patients who are generally satisfied with the size of their breasts can have a breast lift to raise and firm them, resulting in a more youthful breast contour. Some patients may be unhappy that they have lost a significant amount of breast volume over time. In such cases, implants inserted in conjunction with a breast lift can increase breast size at the same time as the shape and position of the breasts are enhanced.
Results of a Breast Lift
Breast lift surgery will make your breasts firmer and more uplifted. The position of your areolas and nipples will be enhanced, and the size of your areolas will be aesthetically pleasing.
The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.
How long will the results last?
Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.
Maintaining a Relationship with Your Plastic Surgeon
You will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Once the immediate postoperative follow-up is complete, many surgeons encourage their patients to come back for periodic checkups to observe and discuss the long-term results of surgery.
Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.
Loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast-feeding ultimately affect the shape and firmness of your breasts. Patients who are generally satisfied with the size of their breasts can have a breast lift to raise and firm them, resulting in a more youthful breast contour. Some patients may be unhappy that they have lost a significant amount of breast volume over time. In such cases, implants inserted in conjunction with a breast lift can increase breast size at the same time as the shape and position of the breasts are enhanced.
Results of a Breast Lift
Breast lift surgery will make your breasts firmer and more uplifted. The position of your areolas and nipples will be enhanced, and the size of your areolas will be aesthetically pleasing.
The incisions from your breast lift surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines. Certain individuals may have incision lines that are more noticeable. Fortunately, the incisions for your breast lift are in locations easily concealed by clothing, even low-cut necklines.
How long will the results last?
Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you again become dissatisfied with the appearance of your breasts, you may choose to undergo a second breast lift procedure to restore their more youthful contour and appearance.
Maintaining a Relationship with Your Plastic Surgeon
You will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress will be evaluated. Once the immediate postoperative follow-up is complete, many surgeons encourage their patients to come back for periodic checkups to observe and discuss the long-term results of surgery.
Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.
Breast Augmentation
14/12/08 20:08 Filed in: Body Procedures
What is Breast Augmentation?
Also known as augmentation mammaplasty, breast augmentation involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.
The results will be long-lasting
The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of clothing and swim wear.
Like many women who have had breast augmentation, you may also have a boost in self confidence.
Implants may need to be replaced or revised
It’s important to know that your breast implants are not permanent and may require replacement during your lifetime. You should expect to have future visits with your plastic surgeon to discuss changes in your breasts.
Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour.
Also known as augmentation mammaplasty, breast augmentation involves using implants to fulfill your desire for fuller breasts or to restore breast volume lost after weight reduction or pregnancy.
The results will be long-lasting
The results of your breast augmentation surgery will be long-lasting. You will find it easier to wear certain styles of clothing and swim wear.
Like many women who have had breast augmentation, you may also have a boost in self confidence.
Implants may need to be replaced or revised
It’s important to know that your breast implants are not permanent and may require replacement during your lifetime. You should expect to have future visits with your plastic surgeon to discuss changes in your breasts.
Over time, your breasts can change due to aging, weight fluctuations, hormonal factors and gravity. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast lift or implant exchange to restore a more youthful contour.
Microdermabrasion
14/12/08 10:14 Filed in: Skin Rejuvenation
Microdermabrasion is effective in reducing fine lines, "crow's feet," age spots and acne scars. It stimulates the production of skin cells and collagen. It has proven to be a very popular nonsurgical cosmetic procedure; see current American Society for Aesthetic Plastic Surgery (ASAPS) statistics.
Technique:
The hand piece emits crystals onto the surface of the skin, resulting in a gentle abrasion or "polishing" process. Each treatment takes from 30 minutes to an hour. The number of treatments recommended for maximal results can range between 5 and 12, spaced from 2 to 3 weeks apart. Maintenance of results requires periodic repeat treatments after the initial regimen is completed. Microdermabrasion may be combined with a light chemical peel to increase the effect.
Benefits:
- Virtually no side effects.
- Gives the skin an overall fresh, healthy-looking glow.
- Nonsurgical, safe, effective "lunch hour" procedure.
- Effective on all skin colors and types.
- No anesthetic required.
- Excellent for skin sensitive to chemical procedures.
- Normal activities can be resumed immediately.
Other Considerations:
- Requires multiple sessions and maintenance treatments.
- Patients with good skin tone will show best results.
- An individualized skin care program may be recommended to maximize results.
Restylane
14/12/08 10:14 Filed in: Skin Rejuvenation
Natural Beauty
Restylane® is the smart and easy way to add volume and smoothness to your skin. Restylane is based on a hyaluronic acid gel that closely resembles the body's own hyaluronic acid. It is long lasting, but not permanent.
Made in Sweden
Restylane is made in Sweden, a nation known for health, nature and beauty. Since 1996, millions of treatments have been successfully performed in more than 70 countries worldwide.
Restylane is an injectable gel which should always administered by a trained, medically qualified practitioner.
Restylane enhances your natural looks by restoring your skin’s volume, creating softness and revitalizing your appearance.
How it works
Youthful skin is rich in hyaluronic acid. As we age, the distribution and function of hyaluronic acid in our skin gradually change, leading to the characteristic signs of aging.
Restylane gels work by enhancing your skin’s own stocks of hyaluronic acid, directly adding volume to either soften the signs of aging or enhance your features.
The procedure is quick. It usually takes less than 30 minutes. The benefits can be seen immediately.
Restylane is produced by Q-Med AB in Sweden under strict laboratory conditions to obtain a high degree of product purity.
Q-Med is a rapidly growing biotechnology/medical device company. Q-Med develops, produces, markets and sells implants for esthetic and medical use. All products are based on the company’s patented NASHA™ technology.
Patented technology
If you injected hyaluronic acid in its natural form into the body, it would break down in just a few days, and any treatment benefit would be very short-lived. The unique stabilization process patented by Q-Med and used in the manufacture of Restylane results in a hyaluronic acid gel that closely resembles the body’s own hyaluronic acid. This provides long-lasting treatment benefits and minimizes the risk of a skin reaction.
Blue Peel
14/12/08 10:14 Filed in: Skin Rejuvenation
A blue peel is a type of chemical facial peel that can also be applied to the arms, hands or neck. The blue peel can lighten age spots and make the skin appear younger and fresher. It does not, however, reduce wrinkles. Most note younger, softer skin, and slightly more elastic skin after a blue peel treatment. Most are very satisfied with a reduction in skin discoloration from blemishes and age spots.
The blue peel uses the chemical Trichloracetic Acid (TCA), which is applied on the skin in one to four separate coats. This application is said to help the skin produce its own collagen. Patients note slight to significant feel of burning on the skin after each coat application. Some patients require anesthesia because they are very uncomfortable. Most have the procedure done without anesthetics.
The blue peel uses the chemical Trichloracetic Acid (TCA), which is applied on the skin in one to four separate coats. This application is said to help the skin produce its own collagen. Patients note slight to significant feel of burning on the skin after each coat application. Some patients require anesthesia because they are very uncomfortable. Most have the procedure done without anesthetics.
Radiesse
14/12/08 10:10 Filed in: Skin Rejuvenation
Radiesse (formerly Radiance) is a biocompatible, non-toxic, non-allergenic filler that reduces the appearance of wrinkles and skin folds around the mouth and nose, and fills certain scars.
Popular for its long-lasting results, Radiesse benefits should be evident for two years or more.
Is Radiesse Right for You?
Radiesse candidates are typically between 35 and 60. Radiesse usually provides up to 80 percent improvement immediately after treatment. Since Radiesse is temporary, treatments must be repeated over the years to maintain the benefit. Alternative treatments or surgical procedures may be more appropriate in years to come, as your condition changes. Discuss expectations with your doctor before treatment.
The Radiesse Procedure
The Radiesse procedure is performed in the doctor's office. It is most often performed with local anesthesia. Patients may experience minimal discomfort from the needle injection. Depending upon the extent of treatment, the procedure can take up to 15 minutes. Patients return home within minutes after the procedure.
The procedure involves injecting a compound of calcium hydroxyl apatite microspheres that are suspended in a carboxymethylcellulose gel. Calcium and phosphate ions, naturally occurring in our bodies, primarily make up the calcium hydroxyl apatite particles. The gel contains an organic compound of carbon, hydrogen, and oxygen, as well as glycerin and sterile water. Thin connective tissue forms around the microspheres so that the microspheres act as a filler that remains permanently implanted at the site location.
Recovery after Radiesse Treatment
There may be minimal swelling, which usually subsides in 24 to 36 hours. There may also be some discomfort and bruising. The discomfort can be managed with medications. Normal activities can be resumed immediately; however, patients are advised to stay out of the sun.
Popular for its long-lasting results, Radiesse benefits should be evident for two years or more.
Is Radiesse Right for You?
Radiesse candidates are typically between 35 and 60. Radiesse usually provides up to 80 percent improvement immediately after treatment. Since Radiesse is temporary, treatments must be repeated over the years to maintain the benefit. Alternative treatments or surgical procedures may be more appropriate in years to come, as your condition changes. Discuss expectations with your doctor before treatment.
The Radiesse Procedure
The Radiesse procedure is performed in the doctor's office. It is most often performed with local anesthesia. Patients may experience minimal discomfort from the needle injection. Depending upon the extent of treatment, the procedure can take up to 15 minutes. Patients return home within minutes after the procedure.
The procedure involves injecting a compound of calcium hydroxyl apatite microspheres that are suspended in a carboxymethylcellulose gel. Calcium and phosphate ions, naturally occurring in our bodies, primarily make up the calcium hydroxyl apatite particles. The gel contains an organic compound of carbon, hydrogen, and oxygen, as well as glycerin and sterile water. Thin connective tissue forms around the microspheres so that the microspheres act as a filler that remains permanently implanted at the site location.
- Step One: The doctor may select one or more injection points for each location to be treated. Antiseptic is also applied.
- Step Two: The doctor will identify the correct amount of Radiesse for the procedure.
- Step Three: The Radiesse filler is then injected beneath the skin, under the dermis and subcutis layer.
Recovery after Radiesse Treatment
There may be minimal swelling, which usually subsides in 24 to 36 hours. There may also be some discomfort and bruising. The discomfort can be managed with medications. Normal activities can be resumed immediately; however, patients are advised to stay out of the sun.
ArteFill
14/12/08 10:09 Filed in: Skin Rejuvenation
ArteFill
ArteFill is a non-resorbable injectable dermal filler for the correction of wrinkles and lines on the face. ArteFill is FDA approved for correctıng smile lines (nasolabial folds) but it is widely used "off label" by physicıans to fill lines and wrinkles all over the face. It is a formulation of medical grade polymethylmethacrylate (PMMA) microspheres and bovine collagen. The PMMA microspheres in ArteFill are not absorbed by the body and therefore provide permanent support for wrinkle correction.
FDA testing
ArteFill was approved by the FDA in October 2006 based on data from a 12-month controlled, randomized, double-blind, clinical trial conducted at medical centers throughout the U.S.A. The study compared outcomes for patients treated with ArteFill with those of patients treated with the bovine collagen dermal fillers Zyderm and Zyplast. A total of 251 subjects were enrolled and had either ArteFill or the collagen control injected to treat their facial wrinkles. When evaluated 6 months after injection, which was the primary evaluation period, the wrinkle correction persisted in patients treated with ArteFill compared to the wrinkle correction in the patients treated with the collagen control, who returned to their pre-treatment status. The ArteFill patients were also evaluated one year after treatment, and demonstrated continued safety and wrinkle correction as compared to baseline and 6 months. The dermal filler products used as controls had lost efficacy by 6 months. A follow-up study of patients from this pivotal trial who were evaluated after a 5-year period has recently been completed. Wrinkle ratings for these patients at five years were compared to baseline and six months after treatment. The results showed continued wrinkle correction at five years, and the data have been accepted for publication.
History
Medical grade PMMA has been used for decades (50+ years) in a variety of medical applications including intraocular lenses to treat cataracts, artificial joints, etc. PMMA microspheres have been used for cosmetic soft tissue augmentation outside of the USA in an estimated 200,000 procedures over the past 10 years. The PMMA technology has undergone many years of product development--first in Europe and then in the United States. Artecoll, an earlier product using this PMMA technology, was manufactured and sold in Europe and Canada. The following changes were made to further enhance the product for introduction into the USA as ArteFill: 1) manufacturing the PMMA at a facility owned by a USA based company (Artes Medical) and inspected by the FDA, 2) refinement of the PMMA microspheres and manufacturing process, with tightening of the specifications for the PMMA, and 3) manufacturing the bovine collagen at an approved, dedicated, USDA inspected facility in the United States. The FDA then approved ArteFill for marketing in the United States in October 2006.
Current usage
ArteFill is an FDA-approved non-resorbable wrinkle filler used by dermatologists and plastic surgeons for the correction of smile lines known as nasolabial folds. ArteFill is only sold to physicians who have undergone product training. ArteFill is different from temporary dermal fillers which are eventually absorbed by the body and require repeat injections. The PMMA microspheres in ArteFill are not absorbed by the body. These microspheres provide a permanent supportive foundation for long-lasting wrinkle correction. ArteFill is injected underneath the wrinkle, just above the skin’s fat layer. The treatment itself is similar to that of temporary dermal fillers like Radiesse, Restylane or Juvéderm. It involves injections with a fine needle over a few minutes. Patients resume normal activities immediately and most patients require 1 or 2 treatments, depending on the depth of their wrinkles and folds.
ArteFill is a non-resorbable injectable dermal filler for the correction of wrinkles and lines on the face. ArteFill is FDA approved for correctıng smile lines (nasolabial folds) but it is widely used "off label" by physicıans to fill lines and wrinkles all over the face. It is a formulation of medical grade polymethylmethacrylate (PMMA) microspheres and bovine collagen. The PMMA microspheres in ArteFill are not absorbed by the body and therefore provide permanent support for wrinkle correction.
FDA testing
ArteFill was approved by the FDA in October 2006 based on data from a 12-month controlled, randomized, double-blind, clinical trial conducted at medical centers throughout the U.S.A. The study compared outcomes for patients treated with ArteFill with those of patients treated with the bovine collagen dermal fillers Zyderm and Zyplast. A total of 251 subjects were enrolled and had either ArteFill or the collagen control injected to treat their facial wrinkles. When evaluated 6 months after injection, which was the primary evaluation period, the wrinkle correction persisted in patients treated with ArteFill compared to the wrinkle correction in the patients treated with the collagen control, who returned to their pre-treatment status. The ArteFill patients were also evaluated one year after treatment, and demonstrated continued safety and wrinkle correction as compared to baseline and 6 months. The dermal filler products used as controls had lost efficacy by 6 months. A follow-up study of patients from this pivotal trial who were evaluated after a 5-year period has recently been completed. Wrinkle ratings for these patients at five years were compared to baseline and six months after treatment. The results showed continued wrinkle correction at five years, and the data have been accepted for publication.
History
Medical grade PMMA has been used for decades (50+ years) in a variety of medical applications including intraocular lenses to treat cataracts, artificial joints, etc. PMMA microspheres have been used for cosmetic soft tissue augmentation outside of the USA in an estimated 200,000 procedures over the past 10 years. The PMMA technology has undergone many years of product development--first in Europe and then in the United States. Artecoll, an earlier product using this PMMA technology, was manufactured and sold in Europe and Canada. The following changes were made to further enhance the product for introduction into the USA as ArteFill: 1) manufacturing the PMMA at a facility owned by a USA based company (Artes Medical) and inspected by the FDA, 2) refinement of the PMMA microspheres and manufacturing process, with tightening of the specifications for the PMMA, and 3) manufacturing the bovine collagen at an approved, dedicated, USDA inspected facility in the United States. The FDA then approved ArteFill for marketing in the United States in October 2006.
Current usage
ArteFill is an FDA-approved non-resorbable wrinkle filler used by dermatologists and plastic surgeons for the correction of smile lines known as nasolabial folds. ArteFill is only sold to physicians who have undergone product training. ArteFill is different from temporary dermal fillers which are eventually absorbed by the body and require repeat injections. The PMMA microspheres in ArteFill are not absorbed by the body. These microspheres provide a permanent supportive foundation for long-lasting wrinkle correction. ArteFill is injected underneath the wrinkle, just above the skin’s fat layer. The treatment itself is similar to that of temporary dermal fillers like Radiesse, Restylane or Juvéderm. It involves injections with a fine needle over a few minutes. Patients resume normal activities immediately and most patients require 1 or 2 treatments, depending on the depth of their wrinkles and folds.
Botox
14/12/08 10:08 Filed in: Skin Rejuvenation
Botox
Also called: Botulinum toxin type A
Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including
Also called: Botulinum toxin type A
Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including
- Temporary removal of facial wrinkles
- Severe underarm sweating
- Cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions
- Blepharospasm - uncontrollable blinking
- Strabismus - misaligned eyes
Juvederm
14/12/08 10:07 Filed in: Skin Rejuvenation
Juvéderm, one of the newest of the so-called “injectable fillers,” is used by cosmetic, dermatological and plastic surgeons to soften deep folds and reduce wrinkles in the faces of patients. The substance is largely comprised of hyaluronic acid, a substance normally found in the skin, muscles, and tendons of mammals. Approved in June 2006 by the U.S. Food and Drug Administration, Juvéderm’s prime use is removing nasolabial folds, or “smile lines,” creases of skin which run from the corners of the nose to the corners of the mouth. It is also used as a lip augmentation agent, and to fill in hollow places and scars on the face. However, all hyaluronic acid facial filler products are eventually absorbed by the body, usually within six to nine months, causing the patient to undergo repeat injections to maintain the younger look. Juvéderm is also used by physicians to plump up lips, which also lose fat and internal shape with normal aging.
FDA testing
Before being released onto the U.S. market, Juvéderm was compared with Zyplast dermal filler, a bovine-based injectable facial filler made from collagen. In clinical studies conducted at several U.S. medical centers to evaluate safety and efficacy, or effectiveness, 146 subjects were followed for 24 weeks. The subjects had Juvéderm injected into one nasolabial fold and Zyplast in the other. Using scientific measuring scales, Juvéderm was deemed to provide a more persistent correction in the subjects’ facial folds. At the end of the study, the researchers asked subjects to judge which fold looked better to them. Eightyeight percent chose the area treated with Juvéderm. Before FDA approval, two other clinical studies on Juvéderm were done on a total of 293 subjects in the United States. The safety profile and effectiveness was found to be similar to the first test.
History
In 1934, medical researchers Karl Meyer and John Palmer, scientists at Columbia University in New York, found that one of the chief functions of hyaluronic acid is maintaining skin volume and hydration, along with other body maintenance functions and tasks.
Meyer and Palmer first isolated the substance from the eye of a cow and named hyaluronic acid by combining the Greek word for glass -- hyalos -- and the uronic sugar contained in hyaluronic acid.
Hyaluronic acid later found uses in the baking and food industry in the 1940s and, by the 1990s, found its way into the medical field for use in joint pain, treating wounds, eye surgery and, finally, in 1996, for facial tissue augmentation in Europe.
Current usage
Juvéderm’s current competitive edge in cosmetic surgery is possible because, according to the manufacturers, Juvéderm is “cross linked.” In hyaluronic acid’s natural form, the substance is a liquid which the body metabolizes in about half a day. Cross linking is a process that chemically binds the individual chains of the acid so that it is changed into a gel that lasts much longer once injected inside the face. Several other facial fillers used in Europe and the U.S. -- like Restylane, Belotero and Hylaform -- are also cross-linked, with competition driving the other fillers toward even more highly cross linked compounds, according to Professor Berthold Rzany, professor of dermatology at the Charité Universitätsmedizin Berlin Germany.
Mechanism of action
Juvéderm works well for cosmetic and plastic surgery applications because hyaluronic acid can absorb up to 1,000 times its own weight in water, thereby adding new volume under the surface of sagging skin. Older faces take on more youthful aspects because hyaluronic acid is known to bind with collagen -- the material that supports human facial skin -- and elastin to move more basic nutrients into the skin.
When the University of Michigan organized a study on the dermal filler Restylane -- a close chemical sibling of Juvéderm -- researchers found that hyaluronic acid stretches cells in skin known as fibroblasts in a way that causes the skin to create new collagen. The new collagen helps decrease the appearance of facial creases and wrinkles. An unexpected -- and welcome -- finding cropped up: hyaluronic acid also seems to stop the breakdown of existing collagen.
FDA testing
Before being released onto the U.S. market, Juvéderm was compared with Zyplast dermal filler, a bovine-based injectable facial filler made from collagen. In clinical studies conducted at several U.S. medical centers to evaluate safety and efficacy, or effectiveness, 146 subjects were followed for 24 weeks. The subjects had Juvéderm injected into one nasolabial fold and Zyplast in the other. Using scientific measuring scales, Juvéderm was deemed to provide a more persistent correction in the subjects’ facial folds. At the end of the study, the researchers asked subjects to judge which fold looked better to them. Eightyeight percent chose the area treated with Juvéderm. Before FDA approval, two other clinical studies on Juvéderm were done on a total of 293 subjects in the United States. The safety profile and effectiveness was found to be similar to the first test.
History
In 1934, medical researchers Karl Meyer and John Palmer, scientists at Columbia University in New York, found that one of the chief functions of hyaluronic acid is maintaining skin volume and hydration, along with other body maintenance functions and tasks.
Meyer and Palmer first isolated the substance from the eye of a cow and named hyaluronic acid by combining the Greek word for glass -- hyalos -- and the uronic sugar contained in hyaluronic acid.
Hyaluronic acid later found uses in the baking and food industry in the 1940s and, by the 1990s, found its way into the medical field for use in joint pain, treating wounds, eye surgery and, finally, in 1996, for facial tissue augmentation in Europe.
Current usage
Juvéderm’s current competitive edge in cosmetic surgery is possible because, according to the manufacturers, Juvéderm is “cross linked.” In hyaluronic acid’s natural form, the substance is a liquid which the body metabolizes in about half a day. Cross linking is a process that chemically binds the individual chains of the acid so that it is changed into a gel that lasts much longer once injected inside the face. Several other facial fillers used in Europe and the U.S. -- like Restylane, Belotero and Hylaform -- are also cross-linked, with competition driving the other fillers toward even more highly cross linked compounds, according to Professor Berthold Rzany, professor of dermatology at the Charité Universitätsmedizin Berlin Germany.
Mechanism of action
Juvéderm works well for cosmetic and plastic surgery applications because hyaluronic acid can absorb up to 1,000 times its own weight in water, thereby adding new volume under the surface of sagging skin. Older faces take on more youthful aspects because hyaluronic acid is known to bind with collagen -- the material that supports human facial skin -- and elastin to move more basic nutrients into the skin.
When the University of Michigan organized a study on the dermal filler Restylane -- a close chemical sibling of Juvéderm -- researchers found that hyaluronic acid stretches cells in skin known as fibroblasts in a way that causes the skin to create new collagen. The new collagen helps decrease the appearance of facial creases and wrinkles. An unexpected -- and welcome -- finding cropped up: hyaluronic acid also seems to stop the breakdown of existing collagen.
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