Introduction: Dermal fillers industry is ever-expanding. Tens, if not hundreds, of brands are available to purchase legally or illegally. I have attempted in this paper to develop a scoring system for Hyaluronic acid ...Introduction: Dermal fillers industry is ever-expanding. Tens, if not hundreds, of brands are available to purchase legally or illegally. I have attempted in this paper to develop a scoring system for Hyaluronic acid dermal fillers that makes an injector’s verdict objective, fair and unbiased, and injection experience safer. Theoretically speaking, the worst filler will have, at least, ᆠ score and the best will have a score of 34 points. Some scoring points do not exist in any filler, suggesting hints to improve all brands. Objectives: To build a Hyaluronic acid dermal filler scoring system that deals with what the injector can easily read, see or experience on their own without using sophisticated technologies or the need to understand or estimate the physics or the chemistry behind the filler. Using a scoring system that depends more on objective than subjective findings will be easy and unbiased to apply, more practical. The scoring system structure should be holistic rather than being only results centered and more focused on safety.展开更多
Background: Nowadays, the use of dermal fillers for correcting signs of aging, such as wrinkles, depressions, and folds, has become increasingly popular. However, the abuse of these products can lead to disfigurements...Background: Nowadays, the use of dermal fillers for correcting signs of aging, such as wrinkles, depressions, and folds, has become increasingly popular. However, the abuse of these products can lead to disfigurements and unpredictable consequences among users. Objective: To evaluate the clinical abnormalities related to dermal fillers abuse in Iraqi people, and identify the various factors contributing to them. Methods: A total of 35 patients with different facial abnormalities due to the abuse of dermal fillers, attending our clinic in Diwaniyah, Iraq, from September 2016 to December 2017, were enrolled. A questionnaire-based analysis was used to collect clinical and sociodemographic data from patients to determine the etiological profile behind this problem. Several disfigurements and facial defects were diagnosed on clinical base. We have treated most of the situations that require intervention and treatment. Results: A total of 35 patients aged between 25 and 54 years with a sex ratio of 0.093 were enrolled in this study. Their mean age was 42 years, and the age group between 35 and 45 years was forming 85.7% of the cases. The clinical abnormalities recorded in this study include: buffy face 8 (22.8%), facial asymmetry 3 (8.5%), Mdoka fish lips like 6 (17%), periorbital redness 1 (2.8%), filler fatigue 6 (17%), bags under eyes 4 (11.4%), sizeable bulbous nose 4 (11.4%), topographical changes 2 (5.7%), and stone-like cheeks 1 (2.8%). The leading causes for the abuse of fillers were as follows: 12 (34.28%) candidates were not compatible with the procedure, 9 (25.7%) were non-compliance with the indications of the Food and Drug Organization (FDA), 9 (25.7%) fillers were injected in the wrong place, 18 (51.4%) injections were of a larger quantity than required, and 5 (14.2%) had frequent and long-term injection. Conclusion: The use of dermal fillers for a wrong purpose can result in disfigurements rather than beautification. The commonest disfigurements are the puffy face, enlarged lips, and bags under eyes. The clinical uses of dermal fillers in Iraq need to be monitored by the health authorities, with the assurance that these products should be sold only by a doctor’s prescription to reduce their abuse.展开更多
With the increased demand for dermal filler injections, more complications and adverse events are reported. Vascular occlusion is one of the most serious complications. The need urges to adopt a powerful protocol to m...With the increased demand for dermal filler injections, more complications and adverse events are reported. Vascular occlusion is one of the most serious complications. The need urges to adopt a powerful protocol to manage such cases. The private practice I am working for has six branches in the middle east. I tried to investigate if there were any vascular occlusion incidences through the last three years. Four cases without sufficient details were found. A protocol was adopted from a scientific reference to deal with similar cases properly. A re-audit was done after six months to test the efficiency of the suggested protocol.展开更多
The demand for injectable dermal filler has unde rgone significant growth with the rapid development of the beauty industry.Poly(lactic acid)(PLA) as a benefit of excellent biocompatibility and long-term promotion of ...The demand for injectable dermal filler has unde rgone significant growth with the rapid development of the beauty industry.Poly(lactic acid)(PLA) as a benefit of excellent biocompatibility and long-term promotion of collagen regeneration has been favored as a commonly used filler.However,the effects of chirality and particle size of PLA on the efficacy of dermal filler have not been studied.In this study,we prepared three kinds of microspheres(MSs) consisting of poly(D-lactic acid)(PDLA MS),poly(L-lactic acid)(PLLA MS),or meso-PLA(PDLLA MS)at 5,10 and 20 μmto reveal the different biological functions as dermal filler.Following intradermal injection into guinea pig,it was found that PLLA MS induced the slightest inflammation,and the level of pro-inflammatory cytokine IL-1β induced by PLLA MS is only 0.3 or 0.7-fold of that induced by PDLA or PDLLA MS,respectively.More importantly,PLLA MS significantly stimulated the regeneration of collagen,which was 1.4 or 1.1 times higher than those stimulated by PDLA MS or PDLLA MS,respectively.The size of PLA MSs did not affect the levels of inflammation and collagen regeneration.The results confirmed the superiority of PLLA as a dermal filler.展开更多
This paper sets out to demonstrate that scraping of the flat dorsal surface of human dermis with a scalpel blade and cell plating without centrifugation can lead to the recognition and identification of the individual...This paper sets out to demonstrate that scraping of the flat dorsal surface of human dermis with a scalpel blade and cell plating without centrifugation can lead to the recognition and identification of the individual packing micro pattern of dermal reticular fibroblasts at confluence. The characteristic alignment of papillary and reticular fibroblasts at right angles to each other led to the positive identification of reticular fibroblasts. A non-enzymatic means of sub-culturing (passaging), which yields fully functional, healthy cells with normal, phenotypic morphology is also described. Implications for published subcutaneous wound healing studies are discussed as well as the confluent reticular fibroblast configuration, interpreted as ananatomic site identity code,which may be the address of a specific fibroblast gene pattern expression.展开更多
Hylauronic acid (HA) is used as a viscoelastic in Ophthalmology during cataract surgery based on its high viscosity at rest, its ability to shear thin and dissipate energy during phacoemulsification. However, these pr...Hylauronic acid (HA) is used as a viscoelastic in Ophthalmology during cataract surgery based on its high viscosity at rest, its ability to shear thin and dissipate energy during phacoemulsification. However, these properties of HA solutions would make them susceptible to migration when used as dermal filler materials. In this study, we apply a new technique termed vibrational optical coherence tomography (VOCT) to compare the physical properties of different HA solutions and fillers used in facial aesthetics. Results presented in this study suggest that HA solutions and HA dermal fillers have markedly different physical properties. HA solutions are highly viscoelastic with high % viscous losses while fillers tend to have lower viscous energy dissipation properties. Clinical observations suggest that the high loss fillers are injected more superficially in the face where tension and internal and external forces are more likely minimized giving tissue of the hands and lips more volume and allowing more natural movement. In contrast, the lower loss gels that are used to lift tissue, generally have a higher G’, and are injected deeper into the face where injection and internal forces are likely to be higher. It is concluded that HA filler gel design can be optimized by use of VOCT to evaluate the % viscous energy loss both in vitro and in vivo.展开更多
Objective:As the population ages,facial plastic providers must remain aware of the treatments to prevent and reverse the external signs of aging.In the mandibular region,skin laxity and soft tissue sagging in the jawl...Objective:As the population ages,facial plastic providers must remain aware of the treatments to prevent and reverse the external signs of aging.In the mandibular region,skin laxity and soft tissue sagging in the jawline may lead to jowling and chin ptosis along with reduced chin projection.While surgical procedures,including chin implantation,may be performed,nonsurgical procedures are becoming increasingly popular due to their temporary,noninvasive,yet effective methods.This review covers the use of hyaluronic acid,calcium hydroxylapatite,poly-L-lactic acid,and polymethyl methacrylate in the jawline.Methods:PubMed was searched for data on the mechanism of action,pertinent anatomy,indications,contraindications,technique,and evidence supporting the safety and efficacy of the fillers.Results:There are a wide variety of fillers available for use in the lower face with unique characteristics and application methods.While the advantages of injectable fillers include relatively affordable cost,minimal patient discomfort,and limited recovery times,taking measures to prevent short-and long-term complications is necessary for optimal results.Conclusions:Understanding the benefits and limitations of injectable fillers in the jawline can help providers appropriately counsel and treat patients.展开更多
文摘Introduction: Dermal fillers industry is ever-expanding. Tens, if not hundreds, of brands are available to purchase legally or illegally. I have attempted in this paper to develop a scoring system for Hyaluronic acid dermal fillers that makes an injector’s verdict objective, fair and unbiased, and injection experience safer. Theoretically speaking, the worst filler will have, at least, ᆠ score and the best will have a score of 34 points. Some scoring points do not exist in any filler, suggesting hints to improve all brands. Objectives: To build a Hyaluronic acid dermal filler scoring system that deals with what the injector can easily read, see or experience on their own without using sophisticated technologies or the need to understand or estimate the physics or the chemistry behind the filler. Using a scoring system that depends more on objective than subjective findings will be easy and unbiased to apply, more practical. The scoring system structure should be holistic rather than being only results centered and more focused on safety.
文摘Background: Nowadays, the use of dermal fillers for correcting signs of aging, such as wrinkles, depressions, and folds, has become increasingly popular. However, the abuse of these products can lead to disfigurements and unpredictable consequences among users. Objective: To evaluate the clinical abnormalities related to dermal fillers abuse in Iraqi people, and identify the various factors contributing to them. Methods: A total of 35 patients with different facial abnormalities due to the abuse of dermal fillers, attending our clinic in Diwaniyah, Iraq, from September 2016 to December 2017, were enrolled. A questionnaire-based analysis was used to collect clinical and sociodemographic data from patients to determine the etiological profile behind this problem. Several disfigurements and facial defects were diagnosed on clinical base. We have treated most of the situations that require intervention and treatment. Results: A total of 35 patients aged between 25 and 54 years with a sex ratio of 0.093 were enrolled in this study. Their mean age was 42 years, and the age group between 35 and 45 years was forming 85.7% of the cases. The clinical abnormalities recorded in this study include: buffy face 8 (22.8%), facial asymmetry 3 (8.5%), Mdoka fish lips like 6 (17%), periorbital redness 1 (2.8%), filler fatigue 6 (17%), bags under eyes 4 (11.4%), sizeable bulbous nose 4 (11.4%), topographical changes 2 (5.7%), and stone-like cheeks 1 (2.8%). The leading causes for the abuse of fillers were as follows: 12 (34.28%) candidates were not compatible with the procedure, 9 (25.7%) were non-compliance with the indications of the Food and Drug Organization (FDA), 9 (25.7%) fillers were injected in the wrong place, 18 (51.4%) injections were of a larger quantity than required, and 5 (14.2%) had frequent and long-term injection. Conclusion: The use of dermal fillers for a wrong purpose can result in disfigurements rather than beautification. The commonest disfigurements are the puffy face, enlarged lips, and bags under eyes. The clinical uses of dermal fillers in Iraq need to be monitored by the health authorities, with the assurance that these products should be sold only by a doctor’s prescription to reduce their abuse.
文摘With the increased demand for dermal filler injections, more complications and adverse events are reported. Vascular occlusion is one of the most serious complications. The need urges to adopt a powerful protocol to manage such cases. The private practice I am working for has six branches in the middle east. I tried to investigate if there were any vascular occlusion incidences through the last three years. Four cases without sufficient details were found. A protocol was adopted from a scientific reference to deal with similar cases properly. A re-audit was done after six months to test the efficiency of the suggested protocol.
基金financially supported by the National Natural Science Foundation of China(Nos.51703012 and 51603204)the Science and Technology Development Program of Jilin Province(No.20190701004GH)。
文摘The demand for injectable dermal filler has unde rgone significant growth with the rapid development of the beauty industry.Poly(lactic acid)(PLA) as a benefit of excellent biocompatibility and long-term promotion of collagen regeneration has been favored as a commonly used filler.However,the effects of chirality and particle size of PLA on the efficacy of dermal filler have not been studied.In this study,we prepared three kinds of microspheres(MSs) consisting of poly(D-lactic acid)(PDLA MS),poly(L-lactic acid)(PLLA MS),or meso-PLA(PDLLA MS)at 5,10 and 20 μmto reveal the different biological functions as dermal filler.Following intradermal injection into guinea pig,it was found that PLLA MS induced the slightest inflammation,and the level of pro-inflammatory cytokine IL-1β induced by PLLA MS is only 0.3 or 0.7-fold of that induced by PDLA or PDLLA MS,respectively.More importantly,PLLA MS significantly stimulated the regeneration of collagen,which was 1.4 or 1.1 times higher than those stimulated by PDLA MS or PDLLA MS,respectively.The size of PLA MSs did not affect the levels of inflammation and collagen regeneration.The results confirmed the superiority of PLLA as a dermal filler.
文摘This paper sets out to demonstrate that scraping of the flat dorsal surface of human dermis with a scalpel blade and cell plating without centrifugation can lead to the recognition and identification of the individual packing micro pattern of dermal reticular fibroblasts at confluence. The characteristic alignment of papillary and reticular fibroblasts at right angles to each other led to the positive identification of reticular fibroblasts. A non-enzymatic means of sub-culturing (passaging), which yields fully functional, healthy cells with normal, phenotypic morphology is also described. Implications for published subcutaneous wound healing studies are discussed as well as the confluent reticular fibroblast configuration, interpreted as ananatomic site identity code,which may be the address of a specific fibroblast gene pattern expression.
文摘Hylauronic acid (HA) is used as a viscoelastic in Ophthalmology during cataract surgery based on its high viscosity at rest, its ability to shear thin and dissipate energy during phacoemulsification. However, these properties of HA solutions would make them susceptible to migration when used as dermal filler materials. In this study, we apply a new technique termed vibrational optical coherence tomography (VOCT) to compare the physical properties of different HA solutions and fillers used in facial aesthetics. Results presented in this study suggest that HA solutions and HA dermal fillers have markedly different physical properties. HA solutions are highly viscoelastic with high % viscous losses while fillers tend to have lower viscous energy dissipation properties. Clinical observations suggest that the high loss fillers are injected more superficially in the face where tension and internal and external forces are more likely minimized giving tissue of the hands and lips more volume and allowing more natural movement. In contrast, the lower loss gels that are used to lift tissue, generally have a higher G’, and are injected deeper into the face where injection and internal forces are likely to be higher. It is concluded that HA filler gel design can be optimized by use of VOCT to evaluate the % viscous energy loss both in vitro and in vivo.
文摘Objective:As the population ages,facial plastic providers must remain aware of the treatments to prevent and reverse the external signs of aging.In the mandibular region,skin laxity and soft tissue sagging in the jawline may lead to jowling and chin ptosis along with reduced chin projection.While surgical procedures,including chin implantation,may be performed,nonsurgical procedures are becoming increasingly popular due to their temporary,noninvasive,yet effective methods.This review covers the use of hyaluronic acid,calcium hydroxylapatite,poly-L-lactic acid,and polymethyl methacrylate in the jawline.Methods:PubMed was searched for data on the mechanism of action,pertinent anatomy,indications,contraindications,technique,and evidence supporting the safety and efficacy of the fillers.Results:There are a wide variety of fillers available for use in the lower face with unique characteristics and application methods.While the advantages of injectable fillers include relatively affordable cost,minimal patient discomfort,and limited recovery times,taking measures to prevent short-and long-term complications is necessary for optimal results.Conclusions:Understanding the benefits and limitations of injectable fillers in the jawline can help providers appropriately counsel and treat patients.
