Verpaele Alexis, Strand Anders
Aesthet Surg J. 2006 Jan-Feb;26(1S):S10-7. doi: 10.1016/j.asj.2005.09.009.
For people requiring large volumes to shape facial contours, add volume to a sunken midface, or correct asymmetry, the options today are limited. Fat injections for adding volume, solid implants for cheeks and chin enhancement, face lift and injectable permanent or semi-permanent products are some of the alternatives used. With the trend towards less invasive and nonpermanent alternatives to plastic surgery, the use of injectable filler materials for facial rejuvenation and correction of soft-tissue defects is becoming increasingly popular. These materials provide volume expansion within the dermis, thereby smoothing out overlying facial wrinkles and enhancing facial contours. Ease of application, minimal procedural discomfort, and rapid patient recovery make injectable fillers well suited for outpatient use. Ideally, a filler material should be biocompatible, nontoxic, nonimmunogenic, and nonmigratory. Several biomaterials have been developed, such as bovine collagen, autologous and allogeneic human collagen, autologous fat, fibroblasts, and hyaluronic acid. However, although they are largely biocompatible, reabsorption and lack of sustained cosmetic effect are major drawbacks. Non-animal stabilized hyaluronic acid (NASHA) offers a longer-lasting aesthetic effect than bovine collagen or avian hyaluronic acid in facial soft-tissue augmentation, and a potentially lower risk of inflammatory reactions. Restylane SubQ is a new NASHA product indicated for deep subcutaneous or supraperiostal injection to replace volume loss in facial adipose tissues and create more defined facial contours.
对于那些需要大量材料来塑造面部轮廓、填充凹陷的中面部或矫正不对称的人来说，目前的选择有限。增加容量的脂肪注射、用于丰脸颊和下巴的固体植入物、面部提升以及可注射的永久性或半永久性产品都是一些可供选择的方法。随着整形手术向侵入性更小、非永久性替代方法发展的趋势，使用可注射填充材料进行面部年轻化和矫正软组织缺陷越来越受欢迎。这些材料在真皮层内提供容量扩张，从而抚平面部皱纹并增强面部轮廓。易于应用、手术不适最小以及患者恢复迅速使得可注射填充剂非常适合门诊使用。理想情况下，填充材料应具有生物相容性、无毒、无免疫原性且不迁移。已经开发了几种生物材料，如牛胶原蛋白、自体和异体人胶原蛋白、自体脂肪、成纤维细胞和透明质酸。然而，尽管它们在很大程度上具有生物相容性，但重吸收和缺乏持久的美容效果是主要缺点。非动物稳定透明质酸（NASHA）在面部软组织填充方面比牛胶原蛋白或禽类透明质酸具有更持久的美学效果，并且炎症反应的潜在风险可能更低。瑞蓝SubQ是一种新型NASHA产品，适用于深部皮下或骨膜上注射，以替代面部脂肪组织的容量损失并塑造更清晰的面部轮廓。
