Hydrogel
is a permanent soft tissue filler. It is made from 5% polyacrylamide
gel and 95% water. The cross-linked Polyacrylamide forms a real gel
that is very similar and highly bio-compatible to human soft tissue.
The gel is injected beneath the skin or muscle (depending on different
places) where it can't be seen or felt and remains in place
permanently. One week after injection there will form a very thin
membrane around the implant which helps to keep it in place. It moves
with facial expressions because it's very elastic. It is easy to
inject, permanent effect, and can be removed at any time after
injection.
During the past 6 years since 1997, more than 20 million ml
of hydrogel has been used to treat over 300 thousand patients.
Since first launch in 1997, PAAG has been
used all over the world, including Asia, Europe, United States, South
America, etc. A large number of animal tests and clinic studies done by
big government hospitals and universities proved that the Medical
Polyacrylamide Hydrogel(PAAG) is a safe, ideal and effective
soft-tissue filling cosmetic material, because it is high inertia, good
biologic compatibility, no chemical reactions within human body.
Hydrogel may be used for:
BUTTOCKS AUGMENTATION - This is the most common use for Hydrogel , popular for patients wanting rounder, more firmly shaped buttocks.
Benefits of this procedure over other procedures such as traditional implants or fat grafting are:
1. Hydrogel can mold, shape and increase volume
on the hips, lower, middle and upper part of the buttocks whereas fat
grafting and traditional implants only effect the upper two thirds.
2. Recovery time is minimal
with hydrogel. The procedure itself only takes 45 minutes to 1 1/2
hours with local anesthesia to the buttock area.. After the procedure it
is recommended that you do not sit or lay on your buttock for 24 hours.
Usually the day after the procedure your buttock will be sore and
swollen and some patients will have minor bruising. 48 hours after your
last treatment you may return home and return to normal activities. With
fat grafting you have 8 weeks recovery time for the liposuction and 3
months to see your final results. With the traditional implants you have
2 weeks of not being able to sit or lay on your buttocks and a minimum
one 1 month before returning to normal activities or exercise.
3. Incremental Increases-
Hydrogel allows you the patient to slowly work up to the size and volume
you desire. For example, many women know they want to be bigger but are
not sure how much bigger they want to be. So on the first treatment
they will have for instance 300 cc, and will then have a few days to see
if they like the size and then on their second treatment if they want
more you can then have another 300cc. This series of increases can be
done over a few days, weeks or even a few years.
CALF AUGMENTATION -
Hydrogel is used to enhance the legs, particularly the calves when
the patient wants to improve the shape of their legs, increase the size
of the calves, enlarge the muscle and add definition. Men normally
have calf augmentation to enlarge the calf muscles .Women normally
want to enhance the curves in their lower leg. Calf augmentation
patients are looking for lower legs that are in better balance to the
rest of the body, especially the thighs. Hydrogel calf augmentation it
an outpatient procedure needs neither hospitalization nor general
anesthetic.
CHEEK CHEEKBONE AUGMENTATION –
Hydrogel is used to enhance the facial structure, The cheekbones are
an obvious choice for dramatic changes and improvement. Hydrogel
injections in the cheekbones are for patients who want the high,
prominent cheekbones that are almost universally considered beautiful.
Cheek implants with Hydrogel can balance the facial structure by
correcting a depressed cheek area due to heredity, age-related bone
restoration or facial trauma.
LIP ENHANCEMENT-
Hydrogel is used for lip enhancement to increase both projection and
volume. The lips are generally considered the sensual point on a
woman’s face. Hydrogel is injected into the lips and molded to give a
pleasing sensual shape. At the same time imbalance in the lips is also
corrected by varying the injection on either side of the mouth. This is
an outpatient procedure taking about 30 minutes and does not require
hospitalization nor general anesthetic.
CHIN ENHANCEMENT - Hydrogel
is used for chin enhancement. In order for a face to appear balanced
and in proportion the chin is a point of reference to the cheekbones
and overall face shape. A week chin can be corrected by injection and
molding of Hydrogel to the desired shape. This is often an issue if a
patient is enlarging the cheekbones or the lips by a large degree. This
is an outpatient procedure taking about 50 minutes and does not
require hospitalization nor general anesthetic.
NASOLABIAL FOLDS -
(LAUGHLINES) Hydrogel is used for removing and reducing the laugh
lines from the face. As we get older lines from the outside of the nose
to the corners of the mouth deepen and become permanent. Genetic
factors, age, and smoking are all elements which can accelerate this
process. Hydrogel injections in this are dramatically reduce and even
eliminate this clear sign of aging. This is an outpatient procedure
taking about 30 minutes and does not require hospitalization nor
general anesthetic.
FACIAL WRINKLES - Hydrogel
is used to fill multiple points in the face, including crow’s feet,
deep brow frowns and perioral lines. Any depression where lines or an
unpleasing symmetry is visible is a candidate for Hydrogel injections.
All of these procedures are handled as an outpatient procedure taking
about 30 minutes and do not require hospitalization nor general
anesthetic.
VAGINOPLASTY -
Hydrogel is used to fill vaginal spacial defects and general
beautification of the vaginal area. This is an outpatient procedure
taking about 30 minutes and does not require hospitalization nor
general anesthetic..
What other type of permanent fillers are there?
Silicone. Several forms of
liquid injectable silicone are FDA-approved for ophthalmic but not
cosmetic uses. The American Society for Aesthetic Plastic Surgery has
warned against the use of liquid injectable silicone for cosmetic
purposes pending further investigation. Unfortunately, silicone oil
injections can cause granulomas and long-term inflammatory changes and
can migrate. Several series and anecdotes report the use of liquid
silicone for HIV-related lipoatrophy, building on experience with use
in other forms of lipoatrophy.
Given the potential risk of silicone relative to
alternative agents, it is not a preferred treatment option. Studies
evaluating the risk versus the benefit of silicone oil in
HIV-associated facial lipoatrophy are ongoing.
Expanded Polytetrafluoroethylene (ePTFE) Implants (Gore-Tex/Gore SAM, SoftForm).
These FDA-approved implants are more appropriate for correction of
significant facial abnormalities. They can be inserted using a small
incision while the patient is under local anesthesia. There are
potential problems with lumpiness and physical obviousness of the
implant. In general, cosmetic use of ePTFE implants is reported to
cause adverse events, including movement of the implant, infection,
swelling, induration, and uncommonly extrusion (emergence of the
implant through the skin).
Calcium Hydrogel (Radiance). Preparations
based on calcium hydroxylapatite (CaHA) microspheres suspended in
carboxymethylcellulose gel were first FDA-approved for vocal cord
injections and for use in a range of orthopedic surgery approaches and
in radiology (CaHA is radiopaque) but have also been widely used for
treatment of wrinkles and lip augmentation. CaHA is bioabsorbable over
several years. Reported problems include hardening and
overcollaginization requiring corticosteroid injections. Limited data
exist regarding its use in HIV-associated lipoatrophy.
Polymethylmethacrylate (Artecoll/Artefill).
Polymethylmethacrylate (PMMA) in smooth
microspheres suspended in bovine collagen has also been approved by the
FDA. The bovine collagen in the implant is reabsorbed over time, but
the presence of the PMMA microspheres generates new collagen production
in that same site. PMMA has been used in Europe for close to a decade
and is available in other countries. A large series in Brazil
described its use in HIV-associated lipoatrophy, although clear
systematic collection of safety data was lacking. Side effects reported
included postinjection swelling and pain. Ultrasonographic data
indicated an increase of dermal thickness sustained up to 5 years.
Polyacrylamide gel (Aquamid, Contura, Bio-alcamid).
These agents are not FDA-approved, but they have been used in clinics
in Europe (where they are approved) and Latin America. Reported data
consist mostly of large clinical series accompanied by impressive
photographs. Some systematically collected data have been reported with
Bio-alcamid.
The different polyacrylamide gel products
have similar characteristics. They are relatively viscous and are
injected subcutaneously. Some authors suggest that use of a dental
block is advisable to limit discomfort at the time of facial injection.
Following injection, the substances encapsulate, enabling at least
partial removal, such as with a large-bore needle, at a later time. This
makes them of interest for use in a condition that may partially
resolve over time. In a case series of 73 HIV-infected patients with up
to 3 years of follow-up, "excellent" aesthetic results were reported,
with no episodes of implant dislocation, migration, granuloma, or
allergic reaction recorded.
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