TREATMENT OF FACIAL FURROWS AND RHYTIDES - 10/09/11

Doi : 10.1016/S0733-8635(05)70469-1

Arnold William Klein, MD ^a,^b, Patricia Wexler, MD ^c, Alastair Carruthers, FRCPC ^d,^f, Jean Carruthers, FRCSC ^e,^f

^a Department of Medicine (AWK),

^b UCLA School of Medicine, Los Angeles, California (AWK);

^c Department of Dermatology, Albert Einstein College of Medicine, Bronx, New York (PW);

^d Division of Dermatology (AC),

^e Department of Ophthalmology (JC),

^f University of British Columbia, Vancouver, British Columbia, Canada (AC, JC)

Resumen

Historically, many substances have been used to correct facial soft tissue defects and deficiencies associated with aging. Some, such as adulterated silicones and impure paraffins, often produced cosmetic disasters.^{3 Bailin P.L., Bailin M.D. Collagen implantation: Clinical applications and lesion selection J Dermatol Surg Oncol 1988 ; 14 (Suppl 1) : 49

Haga clic aquí para ir a la sección de Referencias, 12 Castrow F.F., Krull E.A. Injectable collagen implant—Update J Am Acad Dermatol 1983 ; 9 : 889

Haga clic aquí para ir a la sección de Referencias} Other agents, such as pure injectable-grade liquid silicone, although extraordinarily useful in the skilled hands of certain physicians, have been declared illegal by the Food and Drug Administration (FDA). Although there certainly is a consensus on the characteristics of the ideal agent to correct soft tissue deficiencies (Table 1), unfortunately this product does not exist. Nevertheless, we presently have some excellent substances to fill the void. No one of the available agents is applicable to all defects. On the contrary, the depth and type of defect determine the substance to be used (Table 2).

Currently in the United States the most commonly used filling substances are autologous fat and Zyderm/Zyplast (Collagen Corporation, Palo Alto, CA) collagen. Additionally, the use of BOTOX (Allergan, Inc, Irvine, CA) in the upper face and at times the neck has all but revolutionized the cosmetic management of soft tissue defects in these locales.^{61 Orentreich D., Orentreich N. Injectable fluid silicone Dermatologic Surgery New York: Dekker (1988).

Haga clic aquí para ir a la sección de Referencias} Indeed, the prudent use of BOTOX in lower facial areas other than the neck is being attempted by some investigators with experience with this substance. Although this article in no means represents an encyclopedic approach to the available substances for the correction of soft tissue defects (Table 3) it reviews injectable fat, bovine collagen, and BOTOX, ie, those agents most commonly in clinical use in the United States.

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