Tissue Substitution

    Connective tissue substitution
    Deep wrinkles and profile defects of the face as well as narrow lips can be corrected by bolstering the tissue using connective tissue substitutes. The biological implant materials that are tolerated well by the body but are gradually absorbed by the body include collagen, fat from one’s own body, and hyaluronic acid.

    Highly purified bovine collagen as a filling material has been in use as a standard therapy for more than 10 years. The highly purified material is accepted by the connective tissue in the long term and is believed to stimulate the formation of new collagen. As bovine collagen is a substance which is foreign to the body, it first has to be tested by being injected into the underside of the forearm. If no intolerance reaction is observed during a period of 4 weeks, treatment by injecting collagen under wrinkles and tissue defects can be carried out. Allergic reactions may be observed up to 3 weeks after the last injection, but they occur in less than 1 % of cases. The reactions are usually restricted to the place of application and may last for a few months.

    Own body fat
    Injecting fatty tissue material from one’s own body to fill larger profile defects is used with varying degrees of success. This method can also be used for small folds, but this is usually done using hyaluronic acid.

    Hyaluronic acid
    Hyaluronic acid is a natural polysaccharide and an important structural element in the cutaneous connective tissue of the dermis and subcutis as well as in the fluid of the joints. As human hyaluronic acid is virtually identical with that of other mammals, hyaluronic acid in pure form is a biologically well-tolerated substance. For therapy purposes, it is used in liquid form after being freed from all animal proteins.

    When injected, hyaluronic acid gives additional volume to the skin and lips. This allows the contour of the skin to be restored and the volume of the lips to be corrected as desired. Hyaluronic acid is integrated naturally into the tissue, but is gradually absorbed over time in the course of normal tissue renewal.

    All the procedures of this nature can be repeated at intervals of 2 to 4 weeks in order to perform the desired correction in several steps, if necessary. Follow-up corrections are necessary after about 1 year in the case of hyaluronic acid and after about 2 to 3 years in the case of collagen in order to supplement the material that has been absorbed by the body.