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Collagen is one of the building blocks of skin. Some of the organic implants
are forms of collagen which have different agents within their
suspensions and solutions.
Zyderm, Zyplast, and Koken are bovine collagen. Zyderm and Zyplast originate from
the skin of cattle and are milky in appearance, whereas Koken is a clear solution
originating from the skin of calves.
A
significant breakthrough in soft tissue implants is viscoelastic gel (Hylaform
and Restylane). This gel is a derivative of a ubiquitous molecule made of linked
starches (polysaccharides) from modified hyaluronan which is located between the
structural cells of the skin. It acts as a type of intercellular glue. In
the microlipid transfer, fat is taken from one area of the body, usually
from underneath the navel, and injected into the furrows or wrinkles of the same
person. Silicone fluid is an artificial solution of silicon, oxygen, and other
elements. The use of silicone for injecting into wrinkles has not been approved
by the Food and Drug Administration in the United States nor the Health Protection
Branch in Canada. Even so, it has been used by numerous practitioners because
of its permanent nature, although it has been less popular since the advent of
organic implants. Fibrel and microlipid transfers both use substances
from the patient's own body. Fibrel is unique in that it is composed of gelatin
powder and another chemical agent which is mixed with the yellow protein of the
recipient's blood. Artecoll
is made up of three ingredients PMMA (inert microspheres), collagen and a local
anesthetic. The collagen and anesthesia assist in the delivery of the microspheres
through a fine needle. The microspheres are not absorbed by the body. During the
first 90 days after treatment, the injected collagen dissipates and is replaced
with new collagen created by the body, which binds the PMMA microspheres in place.
This provides the much desired permanent effect, however the limitations are the
permanent feel of the microspheres under the skin, the possibility of the material
being misplaced, asymmetry and a long post injection healing period. Medical
Gore-Tex has been used to patch blood vessels since the 1970's and in the
hands of a skilled practitioner can be effective in the treatment of deep furrows
and scars. If it is not properly implanted it can shift out of place. However,
it is not as unforgiving as silicone as it can be removed if it begins to migrate.
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