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| AUGMENTATION TECHNIQUES | OPINION


FACIAL FILLERS AND IMPLANTS


Peter Charlish takes a look at the range of products and procedures available for augmenting facial appearance


were the fastest growing cosmetic surgical procedure carried out in the US in 2011 ® growing faster in popularity than breast augmentation, Botox injections and liposuction combined, in fact. The ASPS attributed the growth in


E


uptake of chinplants, or mentoplasties to give them their correct name, to increased use of video chat technology, an ageing


Ô baby boomerÕ population (it is said that one baby boomer reaches the age of 50 years every 8 seconds), and a desire for success in the workplace. On the whole, a total of 20680 chin


augmentation procedures were carried out in the US in 2011, a 71% increase compared with the previous year, and nearly twice the number of cheek implants. In terms of the number of procedures carried out, there was a fairly even split between the sexes, although the number grew faster among men than women (76% vs 66%). Taking men and women together, the biggest growth was seen in the 40–54-year age group (+77%), followed by those over 55 years of age (+70%).


ARLIER THIS YEAR, THE American Society of Plastic Surgeons (ASPS) revealed that chin augmentation procedures, popularly referred to as ÔchinplantsÕ ,


To put these figures into context, there


were 49% more lip augmentation procedures in 2011 compared with the previous year, and 47% more cheek implant procedures, but only a 9% increase in laser skin resurfacing, a 7% increase in the use of soft tissue fillers, and a 5% increase in the number of facelifts carried out. In total, $10.4 billion was spent on cosmetic procedures in the US in 2011, a 3% increase over 2010.


Mentoplasty is just one facial procedure


implants are all used to add or restore contour and/or proportion to the face.


Restoring contour Mentoplasty is just one facial procedure involving an implant: chin, jaw, nose and cheek implants are all used to add or restore contour and/or proportion to the face, and many soft tissue augmentation procedures are also carried out ® nearly 1.9 million in 2011. Implants are used not only for augmentative or rejuvenative purposes, but also for reconstructive purposes following surgery or trauma. According to the


involving an implant: chin, jaw, nose and cheek


American Society for Aesthetic Plastic Surgery (ASAPS), procedures employing facial implants all follow the same basic pattern. A small incision is made near where the implant will be placed, either in a


crease or inside the mouth at the gum/lip junction, and a small pocket created. The implant is inserted, the wound stitched, and healing takes place over a number of


PETER CHARLISH Principal Analyst, Informa Business Information


email: peter.charlish@informa. com


days. Facial implants are often inserted at the same time that another procedure ® such as a rhytidectomy or rhinoplasty ® is carried out. Injectable soft tissue fillers, on the other


hand, are generally injected into the dermal layer. This approach permits host incorporation of the material owing to the presence of fibroblasts in the extracellular matrix and vasculature of the dermis. The filler material is placed in the subcutaneous layer in situations where it would otherwise have been palpable through the skin. A wide variety of materials have been


used for both soft tissue and bony augmentation since the first facial implant procedures were carried out at the end of the 19th Century. The first to be used successfully were autogenous materials such as bone and cartilage taken from other parts of the body. Indeed, these can be very effective, with some autogenous implants having been shown to survive intact for many years. Adipose tissue obtained from another part of the body is also used, although this is obviously only suitable as a soft tissue substitute, and not for bony augmentation. In the early 1980s, the first


collagen-based fillers appeared. Collagen CorpÕs Zyderm, first approved by the US Food and Drug Administration (FDA) in 1981, was manufactured from collagen derived from a closed herd of cattle and purified for human use. A second-generation Zyderm appeared in 1983, while Zyplast, a bovine collagen cross-linked with glutaraldehyde and


prime-journal.com | June 2012 ❚ 65


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