By Arnold W. Klein
Thoroughly revised and up to date, this moment version includes present discussions of the applied sciences and tendencies for the correction of epidermis defects due to getting older, photodamage, affliction, trauma, and scarring-including sections on microlipoinjection, surgical procedure for the correction of depressed scars and wrinkles, new tools of facial enhancement, the augmentation of pimples scars, HIV facial lipodystrophy, and the usage of Alloderm® and Cymetra™.
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Extra info for Tissue Augmentation in Clinical Practice: Second Edition
A dot is sufﬁcient marking in the donor area. All questions should be answered, and the risks, beneﬁts, and options reviewed again with the patient. The consent form is then signed and witnessed. TECHNIQUE Equipment Very little equipment is necessary for this surgery. A sterile tray with several 10-cc syringes, a female-to-female Luer-lock adapter (Fig. 5 inch Figure 10 Female-to-female adapter. 1% and 16, 18, 22-gauge spinal needles, Coleman1 extraction and injection cannulas, red syringe caps, and gauze pads.
Instead, it seems to stimulate the production of autologous tissue and scar formation via ‘‘lipocytic dermal augmentation’’; and, because the injected fat cells may lose the race with time with respect to nourishment from existing tissues, its use often yields unpredictable correction (16–18). Using solid fat grafts quite often results in successful augmentation of larger soft tissue defects (19–21). However, many physicians feel that a graft simultaneously containing both dermis and fat will take better and more predictably.
17). An even correction, or slight overcorrection, should be attempted and perceived. Figure 12 Undermining of the glabellar crease with 18-gauge NoKor1 (Becton, Dickinson) needle, immediately prior to dermal grafting. Dermal Grafting 35 Figure 13 Undermining of a large depressed lipotrophic acne scar with 18-gauge NoKor1 (Becton, Dickinson) needle. ’’ 36 Swinehart Figure 15 Insertion of dermal graft into a tiny hole made with 18-gauge NoKor1 needle. Figure 16 Larger scars may need more than one graft.