Summary
Background
Facial wrinkles are caused by weakening of the sub-dermal collagen support layer.
Dermal fillers can be used to treat wrinkles, and this double-blind, randomised, single-centre
study compared four fillers: PRI 1, PRI 2 (both porcine collagen), Zyplast® (purified bovine collagen) and Perlane® (cross-linked hyaluronic acid gel).
Methods
79 females (aged 25–55 years) with wrinkles in the upper lip line border were randomised
to PRI 1 (19 patients), PRI 2 (19 patients), Perlane® (23 patients), Zyplast® (18 patients). Patients were assessed at 1 week and 1, 3, 6, 9 and 12 months using
2D images and by mathematically derived facial volume changes using 3D stereophotogrammetry.
Results
All treatments produced larger, less wrinkled, more prominent lips. PRI 1, PRI 2 and
Zyplast® showed similar lip volume gains, with Perlane® showing the greatest upper lip volume increase. All treatments were comparable for
rates of decrease in upper lip volume post-treatment, however, Perlane® maintained higher lip volume gains at each time point. Investigators indicated PRI
1 was significantly easier to deliver than Zyplast®. Patient satisfaction scores were similar, though there was a trend towards greater
dissatisfaction for PRI 1 and PRI 2 at month 9 (p=0.052). Treatment was well-tolerated, with ‘cold sore’ being the most common adverse
event.
Conclusions
Results showed that PRI 1 and PRI 2 were comparable to Perlane® and Zyplast® as dermal fillers. Further rigorous studies are required to establish the performance
of dermal fillers and patient acceptability. We propose the utilisation of stereophotogrammetry
for assessment of volume changes.
Keywords
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References
- A vision-based three-dimensional capture system for maxillofacial assessment and surgical planning.Br J Oral Maxillofac Surg. 1998; 36: 353-357
- Validation of a vision-based, three-dimensional facial imaging system.Cleft Palate Craniofac J. 2003; 40: 523-529
- A new three-dimensional method of assessing facial volumetric changes following orthognathic treatment.Cleft Palate Craniofac J. 2005; 42: 113-120
- Mixed-effects models in S and S-PLUS. Statistics and Computing. vol. 172. Springer-Verlag, New York2000
- Skin filling. Collagen and other injectables of the skin.Dermatol Clin. 2001; 19: 491-508
- A three-dimensional quantitative analysis of lips in normal young adults.Cleft Palate Craniofac J. 2000; 37: 48-54
- Augmentation, enhancement, and implantation procedures for the lips.Otolaryngol Clin North Am. 2002; 35: 87-102
- The aesthetic properties of lips: A comparison of models and non models.Angle Orthod. 2003; 74: 162-166
- The history of substances for soft tissue augmentation.Dermatol Surg. 2000; 26: 1096-1105
- Some new injectable dermal filler materials: hylaform, restylane, and artecoll.J Cutan Med Surg. 1999; 3: 27-35
- Soft tissue fillers: what options are available today?.Aesth Surg J. 1999; 19: 505-507
- The first clinical study using a new biodegradeable implant for the treatment of lips, wrinkles and folds.Aesthetic Plast Surg. 1998; 22: 97-101
- Experiences with a new nonbiodegradable hydrogel (Aquamid): a pilot study.Aesthetic Plast Surg. 2003; 27: 376-380
- Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study.Dermatol Surg. 1998; 24: 1317-1325
- Human anti-hyaluronic acid antibodies: is it possible?.Dermatol Surg. 2001; 27: 185-191
- A classification of facial wrinkles.Plast Reconstr Surg. 2001; 108: 1735-1750
- Pulsed carbon dioxide laser resurfacing of photo-aged facial skin.Arch Dermatol. 1996; 132: 395-402
- Aesthetic and anatomical analysis of the aging skin.Semin Cutan Med Surg. 1996; 15: 134-138
- Overview: soft tissue augmentation.Clin Plast Surg. 2000; 27: 479-487
Article info
Publication history
Published online: November 05, 2008
Accepted:
June 9,
2008
Received:
September 5,
2007
Identification
Copyright
© 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.