Hönig Johannes
University Hospital and Medical School of Goettingen and Paracelsus Clinic Hanover, Germany.
J Craniofac Surg. 2008 Jul;19(4):1085-8. doi: 10.1097/SCS.0b013e31811eda9c.
Lipoatrophy of the face in HIV seropositives are not susceptible to satisfactory correction by using single cosmetic surgery. The limitation of the available filler products to augment and to correct the facial defects in facial lipoatrophy is mainly inherent in the amount of substance that can be implanted for the correction of lipoatrophy. Using Bio-Alcamid, which is an injectable, biocompatible, nontoxic, nonallergenic soft tissue filler designed to correct tissue deficits of various volume by intratissue administration, 9 nonrelated HIV seropositive patients with facial lipoatrophy (7 males and 2 females, age 43 +/- 6 years) underwent cheek augmentation. From 7 mL to 16 mL of substance was injected each on both cheeks per application up to a maximum total of 25 mL. with a mean amount of 12 mL +/- 4 mL. The median follow up time was 2 years. The results revealed that the corrections have remained essentially unchanged throughout the period of follow up. Bio-Alcamid maintained the form and blend with the surrounding tissues. The surgical outcome was evaluated according to the analysis of photographs obtained before and after surgery, the analysis of pre- and postoperative measurements, and patients' self-judgment. The level of satisfaction was significantly high: in 63% of the cases, the result was judged to be excellent and in 32%, good. Only in 5% of the cases the result was considered poor. The present study strongly suggests that Bio-Alcamid is suitable for the correction of remarkable defects of facial atrophy, otherwise treatable only by surgery with myofascial free flaps. In addition, it permits a simplification of facial reconstruction and rejuvenation.
HIV血清阳性患者面部脂肪萎缩难以通过单次整容手术得到令人满意的矫正。现有填充产品在增加和矫正面部脂肪萎缩所致面部缺陷方面存在局限性，这主要源于可用于矫正脂肪萎缩的植入物数量。使用Bio-Alcamid（一种可注射的、生物相容性好、无毒、无过敏反应的软组织填充剂，旨在通过组织内给药矫正不同体积的组织缺损），9例无亲缘关系的面部脂肪萎缩HIV血清阳性患者（7例男性，2例女性，年龄43±6岁）接受了脸颊填充。每次在双颊各注射7 mL至16 mL物质，最多总量为25 mL，平均量为12 mL±4 mL。中位随访时间为2年。结果显示，在整个随访期间矫正效果基本保持不变。Bio-Alcamid保持了形态并与周围组织融合。根据手术前后拍摄的照片分析、术前和术后测量分析以及患者的自我判断对手术结果进行评估。满意度水平显著较高：63%的病例结果被判定为优秀，32%为良好。只有5%的病例结果被认为较差。本研究强烈表明，Bio-Alcamid适用于矫正明显的面部萎缩缺陷，否则只能通过带肌筋膜游离皮瓣手术治疗。此外，它还能简化面部重建和年轻化过程。
