Kim JongSeo
a Kim-JongSeo Plastic Surgery Clinic , Seoul , Korea.
J Cosmet Laser Ther. 2017 Nov;19(7):434-438. doi: 10.1080/14764172.2017.1342037. Epub 2017 Jun 28.
PCL filler can be injected in two major ways to control pain. One such method involves mixing 0.3cc of PCL filler with lidocaine, and the other is the method introduced in this report, which involves pre-injection with a tumescent solution. It is hard to reduce pain effectively with pre-mixing PCL filler with lidocaine because there may be not enough time to act lidocaine solution effect immediately for pain control. The pre-mixing method changes the properties of the original filler, especially the property of the CMC portion. Therefore, in my simple and novel technique, tumescent solution is injected, followed by PCL filler which preserves the original CMC property. This is done after sedation of the tissue by the tumescent solution and dissection of soft tissue to create a space for the ensuing PCL injection. After pre-injection with tumescent solution, histological analysis indicated that the tissue did not become irritated in response to the foreign body material (PCL filler) or the mechanical trauma caused by the needle. That is the key mechanism of the tumescent injection method for reducing tissue reaction and that may reduce pain and swelling during and after PCL filler injections.
聚己内酯（PCL）填充剂可通过两种主要方式注射以控制疼痛。一种方法是将0.3立方厘米的PCL填充剂与利多卡因混合，另一种是本报告中介绍的方法，即预先注射肿胀液。将PCL填充剂与利多卡因预混合很难有效减轻疼痛，因为可能没有足够的时间让利多卡因溶液立即发挥控制疼痛的作用。预混合方法会改变原始填充剂的特性，尤其是羧甲基纤维素（CMC）部分的特性。因此，在我的简单新颖技术中，先注射肿胀液，然后注射PCL填充剂，这样可保留原始的CMC特性。这是在肿胀液使组织镇静并解剖软组织以形成随后注射PCL的空间之后进行的。预先注射肿胀液后，组织学分析表明，组织对异物材料（PCL填充剂）或针头引起的机械创伤没有产生刺激反应。这就是肿胀注射法减少组织反应的关键机制，这可能会减轻PCL填充剂注射期间及之后的疼痛和肿胀。
