Micronized acellular tissue for soft tissue augmentation

Abstract

Anthony P. Sclafani, MD, Chappaqua, NY , is a board-certified otolaryngologist. The modern search for the ideal soft-tissue filler for cosmetic and reconstructive purposes began in earnest at the end of the 19th century with Gersuny's reported use of injectable paraffin fillers.1 Materials for soft-tissue augmentation are numerous and can be organic or inorganic, implantable or injectable. The ideal filler material would be inert, neither transmit nor induce disease, match the surrounding tissue's color and consistency, be easily placed, and maintain its position, bulk, and physical characteristics indefinitely. Despite the many types of materials used to date, the ideal soft-tissue filler has not yet been found. During the first half of the 20th century, little progress was made beyond paraffin. In the postwar period, injectable silicone was introduced, but imprudent use led to chronic foreign body reactions and silicone granulomas. Injectable collagen (Zyderm/Zyplast, Collagen Corporation, Palo Alto, CA) was introduced in the 1980s and has become the standard by which all other injectable filler materials are judged. Injectable collagen is easily placed and associated with few complications, and its application is well tolerated by most patients. As a xenograft, the material requires processing to remove the most immunogenic portions of …