[Soft tissue augmentation for treatment of wrinkles and scars of the face]

Facial wrinkles and scars can be corrected by injecting implants into the dermal connective tissue. Today, several substances can be used for this purpose. Injectable bovine collagen (Zyderm and Zyplast) has been used successfully for more than twenty years in some hundred thousand patients. Due to the xenogenity of the product a skin testing is required before augmentation. As the implant is degraded by the body's own mechanisms periodic maintenance injections are necessary. Gelatin matrix (Fibrel) was developed as an alternative to injectable collagen. It is mainly used for the correction of scars. The long term-correction seems to be better compared to collagen but a skin test must be performed as well. The most promising material for soft tissue augmentation today is hyaluronic acid and its derivatives. The substance is easy to handle and requires no previous skin testing. The efficacy is comparable to collagen. Apart from the biomaterials synthetic implants are still of interest. The augmentation with expanded polytetrafluorothylene (Gore-tex) requires a surgical procedure because a tubular implant is inserted undermeath the wrinkles. The correction is permanent, but scars and an asymmetrie of the face may be complications.