Micrognathia and Microchilia Improved by Filler in a Systemic Scleroderma Patient / 대한피부과학회지

Systemic sclerosis is an autoimmune rheumatic disease of unknown etiology, often manifested with excessive, fibrosis of the skin. The viscous properties of the skin are impaired, and the main histologic changes include a thicker dermis, absence of pilosebaceous units, and a decreased space between collagen bundles. We present a case of 20-year-old Korean woman with micrognathia and microchilia due to systemic sclerosis who came for improvement of her doll-like appearance. We saw an improvement in her micrognathia and microchilia by using Restylane(R) and Perlane(R).

Histology and Stroboscopic Findings after Injection of Artecoll(R) and Restylane(R) into Paralyzed Canine Vocal Fold: in vivo Canine Study / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The aims of this study are to introduce Artecoll and Restaylane, that have been available for facial augmentation, as new materials for injection laryngoplasty, to investigate the mucosal wave of true vocal folds after the injection of these two materials into the true vocal fold, and to assess its biocompatibility and durability. SUBJECTS AND METHOD: After complete paralysisof the right recurrent laryngeal nerve of 6 Beagle dogs, the dogs were divided into the Artecoll injection group and the Restylane injection group, and Artecoll or Restylane was injected into vocalis muscle and vocal ligament. The recurrent laryngeal nerve of the opposite side was stimulated, the posterior commissure was sutured, and the mucosal wave of true vocal folds was examined by stroboscopy in in vivo canine study 1, 3, and 6 months after the injection. And, histopathological change of the injected materials after total laryngectomy was examined by hematoxylin and eosin (H & E) staining and masson trichrome staining. RESULTS: In both the Artecoll injection and the Restylane injection groups, the mucosal wave of true vocal folds was detected by stroboscopic examination until 6 months after the injection, and the difference of the mucosal wave of true vocal folds between these two groups was difficult to detect. Histological studies revealed that the injected materials remained in the vocal ligament and vocalis muscle and theses two materials were resorbed with time, Artecoll showing less resorption. These two materials were biocompatible and, particularly, Restylane showed less foreign body reaction. CONCLUSION: Since both Artecoll and Restylane are biocompatible and durable, they areconsidered as the suitable material for injection larygoplasty, and additional long-term studies are required.

The Injectable Fibroblast-Hyaluronic Acid Complex for Augmentation Rhinoplasty

Although several suspension biomaterials have been considered to be relatively safe and convenient, varying degrees of resorption have required repeated percutaneous injection. In the previous animal study the authors have reported that cultured human fibroblasts suspended in Restylane(R), which is modified hyaluronic acid, could produce human dermal matrices and prolong the effect of this gel. This study was undertaken to evaluate the clinical efficacy of this method. A total of 11 patients ranging from 25 to 57 years of age were included in this study between January of 2002 and December of 2003. All the patients were treated for the purpose of augmentation rhinoplasty. 1x10(7)/ml or 1.5x10(7)/ml cultured fibroblasts were suspended in 0.7 to 1.4ml of Restylane(R). The implants were transferred to a 1-ml syringe and injected subcutaneously to the nose of the patients. Among 11 patients, long term follow-up for more than 1 year was possible in 6 patients. The injected implants remained in site without evidence of resorption or loss of correction. All the patients were satisfied with long term results of this method. There was no complication during the follow-up period.

Advantage of the Presence of Living Dermal Fibroblasts within Restylane(R) for Soft Tissue Augmentation

For the correction of facial wrinkles and skin contour defects, commercially prepared nonanimal stabilized hyaluronic acid(Restylane(R)) is now widely used. Although this suspension has been shown to be relatively safe and convenient to administer, varying degrees of resorption have required repeated percutaneous injection. Therefore, this study was undertaken to evaluate the feasibility of Restylane(R) combined with cultured human dermal fibroblasts to enhance the persistence of the injected implant. For the experimental group, fibroblasts from the dermis of healthy adults were isolated and cultivated. Five hundred thousand fibroblasts suspended in 200mul of Dulbecco's phosphate buffered saline(DPBS) were then dispersed in 200mul of Restylane(R) to form a human fibroblast mixed Restylane(R) that measured 400mul in volume. For the control group, 200mul of DPBS without fibroblasts was mixed with 200mul of Restylane(R) These implants were injected subdermally into the back of athymic nude mice at six sites; control group into the left three sites and experimental group into the right three sites. Twelve nude mice were injected to form total of 36 injections per group. The nodular swellings that resulted from the injections were excised wide enough to include skin beyond the swelling points down to panniculus carnosus layer using 5 mm punches, and the weights were measured at 1, 2, 4, 8, 12, and 16 weeks after the injections. Histologic comparisons were also made to confirm the presence of human collagen in the fibroblast mixed Restylane(R) group using immunohistochemical study with anti-human collagen type I polyclonal antibody. The mean weight of the control group nodules decreased throughout the examination period. The mean weight at 16th week was 60% of the weight at first week. On the other hand, the mean weight of the experimental group nodules decreased over the first 2 weeks only. Beyond 2 weeks, there was no further significant weight change. The mean weight at 16th week was 91% of the weight measured at first week. Histologic examination of the control group taken at each examination period exhibited negative immunohistochemical staining for human collagen. That of experimental group exhibited positive staining after 2 weeks, indicating the presence of human collagen. These results indicated that Restylane(R) mixed with cultured human dermal fibroblasts could be successfully injected as living grafts for long-term retention of the implants.