The Use of Fillers in the Aging Patient

ABSTRACT

To keep pace with advancements made in facial plastic and reconstructive surgery, surgeons continue to search for the ideal soft-tissue filler. A review of the literature reveals the advantages, disadvantages, and indications for the use of injectable collagen, Fibrel, autologous fat, and fascia. Recent studies on the new synthetic injectables methylmethylpolysiloxane (Bioplastique) and polymethylmethacrylate (Artecoll) also illustrate guarded results. Expanded polytetrafluoroethylene (Gore-Tex) has been shown to be biocompatible and clinically effective in a variety of head and neck applications. In 246 consecutive soft-tissue augmentations of nasolabial creases, we found Gore-Tex to efface the depth of crease significantly. In two patients, elective repositioning was performed because of superficial placement; however, there were no instances of extrusion or infection. Preoperative grading of crease severity reveals that an increased number of procedures are required to augment moderately severe or severe nasolabial folds.