For years plastic surgeons have sought a soft tissue filler that would last and be safe as well. Historically, collagen has lasted 3 weeks to 3 months and required multiple visits to the dermatologist or plastic surgeon; this, in the long term is a very expensive method. In addition,, the use of silicone, although an excellent material for filling soft tissue defects, is technique dependent and,, when impure or used improperly leads to considerable bumpiness and soft tissue inflammation. Other materials have come on the market from Europe and elsewhere which have not satisfied the longevity problem. The use of Radiance represents a breakthrough for soft tissue filling for multiple reasons.
First. the ingredients in Radiance have been available and used in medicine for over a decade. The basic inert ingredient, calcium hydroxyapatite, has been used by neurosurgeons, plastic surgeons, and ENT surgeons, to fill bony defects. For this it has worked quite well. When the material escaped into the soft tissue it remained present as radio opaque, that is, visible on x ray for years. Consequently, calcium hydroxyapatite was reduced in particle size and mixed with a vehicle that allowed it to be injected. This is different from one of the substances available in Europe. Artecoll, which also uses an inert substance but mixes it with collagen, which has some history of allergy and obvious resorption.
The new hydroxyapatite mixture has been used for soft tissue fill, mostly internally. For example,, in patients who have a paralyzed vocal cord,, where the other vocal cord cannot meet it appropriately, it has been injected into the paralyzed cord to allow patients to speak. In addition, some women have bladder outlet problems,, where in when they cough or sneeze they tend to urinate. They need some way to reduce the outlet size to make it less incontinent. The injection of this material has been helpful. And finally,, for radiation therapy the classic method for defining the ports for radiation has included placing blue tattoo marks which are permanent on the skin., By injecting this new material one could see the material and the ports quite nicely on x ray, but they were not visible residual stigmata of the radiation therapy on the skin. Follow up x rays showed the material not only to last subcutaneously for considerable periods of time but also to elevate the skin's surface.
Based on its internal injection safety,, trials were started for soft tissue fill in the face. This is an off the shelf use similar to that which happened with Botox. Botox was used primarily for spasms around the eyelids and tics, and for this it worked quite well. Once surgeons and doctors got this material, it was used for the forehead , for crows` feet and other hyper mobile areas, and it worked excellently. After a few years, it was FDA approved also for this method of correcting wrinkles.
This material, Radiance does not after the mobility of the soft tissue.
Nor does it elevate fine lines because is not used subcutaneously; it is used more
deeply in the tissues. As such, it is ideal for soft tissue depressions such as the
nasoiabial folds, occasionally the glabella regions between the eyes and
forehead, and definitely to augment the lips. Materials that have been used to
augment the lips such as fat and collagen are extremely short lived, but this
material lasts for 3 7 years or even 8 years.
The material can be injected painlessly because a block technique is used for upper and lower lip as well as the majority of the nasolabial folds. This art of blocking the nerves was published by Dr. Zide and it allows the surgeon to deposit the material without the patient moving. The anesthesia can last depending on the patients preference 1/2 hour up to 2 hours.The swelling may require a short time to subside. The material is safe with very few complications, and to date in this office we have not seen any patient who is dissatisfied with this method.
We hope this answers the majority of questions about this material. We hope you will then sign the consent, get pre operative pictures, and move forward in your desires to look better for next few years. Thank you very much.
Sincerely,Barry M. Zide M.D.
Professor of Surgery (Plastic)
New York University Medical Center
P.S. If you are happy with this method, please feel free to tell your friends about it,, and please note this office is a full service plastic surgery office with a certified operating room. Dr. Zide is capable of doing many more procedures aside from these straight forward injections to augment the soft tissue.
