• Imaging Science in Dentistry
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• v.48 no.3
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• pp.227-231
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• 2018

In recent years, as interest in maintaining beauty and a youthful appearance has grown, filler procedures such as soft tissue augmentation have become more popular. These fillers are sometimes seen as radiopaque shadows on radiographic images, either due to the fillers themselves or because of secondary reactions; such findings may present a diagnostic challenge to dentists. The present report describes 3 cases of dermal fillers observed in panoramic and cone-beam computed tomographic (CBCT) images. All 3 elderly female patients had filler injected into their cheeks and chin area for cosmetic purposes decades ago. On panoramic images, multiple symmetric radiopacities were observed in the facial area; on CBCT, these calcifications were seen in the subcutaneous tissue in various shapes and with varying density. In conclusion, dentists should be aware of the imaging characteristics of dermal filler, and should be able to differentiate dermal filler from other pathological findings.

• Journal of Microbiology and Biotechnology
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• v.25 no.3
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• pp.399-406
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• 2015

In this study, we developed a composite filler comprising cross-linked hyaluronic acid (HA) and human collagen (COL) derived from the human umbilical cord with the aim of improving its biocompatibility and longevity compared with commercially available fillers. After HA/COL composite fillers were made in two different ratios (10:1 and 5:1), the physical properties of the fillers were evaluated. The interior morphologies and in vivo weight change of these hydrogels were also characterized at 1-16 weeks after injection into mice. To evaluate their biocompatibility and durability in vivo, we injected the composite fillers into nude mice subcutaneously. The variations of injected gel weight were measured and compared with the commercial dermal fillers (Restylane and TheraFill). The composites showed improved or similar physical properties (complex viscosity of 19-22 × 10⁵ cP, and injection force of 10-12 N) over the commercial dermal fillers. Sixteen weeks following the injection, the ratio of remaining composite filler weight to initial weight (75.5 ± 16.9%; 10:1) was shown to be greater than that of the commercial fillers (43.2 ± 8.1%, Restylane; 12.3 ± 5.3%, TheraFill). In addition, immunohistochemical analysis with angiogenesis-related markers such as isolectin and vWF revealed newly formed blood vessels and cellular influx into the composite filler, which were not observed in the other fillers. These results clearly suggest that the HA/COL composite filler is a superior candidate for soft tissue reconstruction. The filler we developed may be a suitable candidate as an injectable dermal filler for tissue augmentation in humans.

• Journal of Biomedical Engineering Research
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• v.40 no.4
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• pp.137-142
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• 2019

Numerous efforts are being made to develop an ideal dermal filler that should be bio-compatibility, non-immunogenicity, long-lasting and biodegradable without a toxic secretion. Biomaterials of dermal fillers are hyaluronic acid filler, calcium filler, PMMA filler and collagen filler depending on the ingredient. Although hyaluronic acid (HA) is most widely used, it has shortages such as short shelf life and low mechanical strength compare to extracellular matrix (ECM). The cartilage ECM composed of collagen type II, proteoglycans, glycosaminoglycans (GAGs) and in a minor part with glycoproteins. In this study, we developed a cartilage ECM injectable filler capable of improving biocompatibility and longevity compared with hyaluronic acid (HA) fillers. The ECM hydrogel was cross-linked by the reaction of N-(3-Dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDC)/N-hydroxysuccinimide (NHS) for mechanical enhancement. Prepared ECM filler was compared with cross-linked HA by butanediol diglycidyle ether (BDDE), which is the most widely used natural polymers for dermal filler. In the results, the articular cartilage ECM hydrogel has great potential as a dermal filler to improve the biophysical and biological performance.

• Archives of Plastic Surgery
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• v.42 no.2
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• pp.232-239
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• 2015

A foreign body granuloma is a non-allergic chronic inflammatory reaction that is mainly composed of multinucleated giant cells. Foreign body granulomas may occur after the administration of any dermal filler. Factors such as the volume of the injection, impurities present in the fillers, and the physical properties of fillers affect granuloma formation. The formation of granulomas involves five phases: protein adsorption, macrophage adhesion, macrophage fusion, and crosstalk. The clinical and pathologic features of granulomas vary depending on the type of filler that causes them. Foreign body granulomas can be treated effectively with intralesional corticosteroid injections. Surgical excisions of granulomas tend to be incomplete because granulomas have ill-defined borders and moreover, surgical excisions may leave scars and deformities.

• Journal of Biomedical Engineering Research
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• v.38 no.1
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• pp.1-8
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• 2017

The successful synthesis of hyaluronic acid micro-threads is very promising approach for the broad application in tissue engineering such as dermal fillers. Because hyaluronic acid has the excellent biocompatibility and ability to maintain the moisture of up to several hundred times its own weight. In order to generate the hyaluronic acid micro-threads in microfluidic system, we employed two-phase flow microfluidic chip to make a rapid synthesis of the hyaluronic acid hydrogel. Hyaluronic acid was mixed with 0.02N NaOH solution and 1, 4-Butanediol diglycidyl ether (BDDE) solution and then injected into core channel. The ethanol was used for the 3-dimensional micro-thread formation in sheath channel. We manipulated the diameter of HA micro-threads using controlling of flow rates in microfluidic chip, and showed the feasibility of immobilization in HA micro-threads with florescent substances. Also, the generated HA micro-threads were evaluated and showed the suitable properties with tensile strength, bending property, and swelling profiles for dermal fillers. As a result, we suggested an innovative method for microfluidic chip-based HA micro-threads which could safely be applied as dermal filler in tissue engineering.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.169-172
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• 2016

Dermal fillers are generally accepted as safe and well-tolerable cosmetic tools. However, adverse reactions have been reported in the literature. Here, we present a case of atypical facial filler granuloma and compare its histologic features with those of the classic paraffinoma.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.7 no.2
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• pp.113-118
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• 2021

Chitosan is a polysaccharide derived from chitin by deacetylation. Chitosan is non-toxic, biodegradable, and biocompatible, so that it can be used in wide variety of medical applications such as wound healing and antimicrobial biomaterials. It also used as dermal fillers due to its ability to inject with liquid formulations. For investigation on in vivo distribution of these chitosans, Bolton-Hunter-conjugated chitosan (Chitosan-BH) was synthesized by the reaction between the primary amino group of chitosan and N-hydroxysuccinimide ester group of Bolton-Hunter reagent. Then Chitosan-BH was radiolabeled with ¹²⁵I (Chitosan-BH-¹²⁵I) using a Chloramine-T method. The effects of each radiolabeling step on the radiolabeling yield of the final product were tested. The results showed that purification step had significant effects on the radiolabeling yield of the final product. Finally, SPECT/CT images were obtained to evaluate in vivo uptake of the radiolabeled chitosan (Chitosan-BH-¹²⁵I) in several organs. The highest uptake was found in the site of injection at 21 days post-injection. The results of this study suggest that chitosan is expected to be useful for biomaterials of dermal fillers.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.340-343
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• 2017

Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient's clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.

• Journal of Oral Medicine and Pain
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• v.47 no.3
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• pp.148-151
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• 2022

Obstructive sialadenitis, one of the diseases that most frequently causes swelling and pain in the salivary glands, is mainly caused by structural obstructions. Sialolithiasis is the most frequent cause of the disease, and other causes include calculus formation, duct strictures, foreign bodies, and anatomical variations. Although there is a possibility that facial fillers directly block the salivary ducts, no cases of obstructive sialadenitis associated with them have been reported yet. We report the case of a 34-year-old female patient who complained of recurrent swelling and pain in the left buccal mucosa. She had undergone facial filler injection procedures on her facial area for cosmetic purposes several years before. Based on the findings of magnetic resonance imaging (MRI) and MR sialography, she was diagnosed with obstructive sialadenitis due to facial fillers. Through this case, we should remember to obtain a thorough history including filler treatments in the case of parotid gland swelling. We also suggest proper utilization of advanced imaging such as MRI in evaluating the location of facial fillers.

• Imaging Science in Dentistry
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• v.50 no.2
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• pp.175-180
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• 2020

Purpose: In this study, we used ultrasonography to monitor the use of hyaluronic acid (HA) as a filler in the face for esthetic reasons. We monitored changes in the filler shape, distribution, and relationship with adjacent anatomical structures over a 180-day period. Materials and Methods: Two patients each received an ultrasound-guided injection of HA, with different products and application sites for each patient. In 1 patient, the injection was administered in the angle of the mandible, while in the other, it was administered in the zygomatic region. The injection sites were monitored via ultrasonography at 24 hours, 30 days, and 180 days, at which times the imaging characteristics of the filler were observed. All injections were performed by the same professional, as were the ultrasound exams, which were conducted using the same equipment. Results: In both cases, the HA fillers were visualized using ultrasound at all time points. Some differences were observed between the cases in the images and the distribution of the pockets of filler. In 1 case, the filler appeared as a dark hypoechoic region with well-defined contours, and the material was observed to have moved posteriorly by the 180-day mark. In the other case, the material appeared hyperechoic relative to the previous case and presented no noticeable changes in its anteroposterior distribution over time. Conclusion: Based on these 2 cases, ultrasonography can be a complementary tool used to monitor facial fillers over the long term, allowing for the dynamic observation of different fillers.