The mastermind behind PMMA, and possibly the person that has had the most extensive research in soft tissue fillers is Prof. Gottfried Lemperle, a German Plastic Surgeon living in Frankfurt, and a gentleman that I have the privilege to call a friend.
Dr. Lemperle is the author and co-author of what it is possible the most extensive research about soft tissue fillers; a wealth of peer-reviewd pre-clinical and clinical publications focusing in PMMA, and extending to other micro-sphere fillers, hyaluronic acid, and other products that have been used in the past.
He has been involved in soft tissue fillers as a scientist, a pioneer and a revolutionary.
We just had a conversation about the importance of collagen and its intricated interaction with soft tissue fillers, and I decided to attach his explanation below:
Dr. Lemperle is the author and co-author of what it is possible the most extensive research about soft tissue fillers; a wealth of peer-reviewd pre-clinical and clinical publications focusing in PMMA, and extending to other micro-sphere fillers, hyaluronic acid, and other products that have been used in the past.
He has been involved in soft tissue fillers as a scientist, a pioneer and a revolutionary.
We just had a conversation about the importance of collagen and its intricated interaction with soft tissue fillers, and I decided to attach his explanation below:
"Collagen is the most complex structures in the body and – as all structures – it is in a continual state of deposition and degradation. It is impossible to determine its overall lifetime, since this is dependent on its location and mechanical stress: it may remain for decades in tendons and cartilage, many years in the dermis.
Vascular collagen has a normal half-life of 2 months; can decrease to 1 week in the case of disease or injury, and only around 4 weeks in unregulated scattered collagen fibers in healing wounds or around dermal fillers.
Vascular collagen has a normal half-life of 2 months; can decrease to 1 week in the case of disease or injury, and only around 4 weeks in unregulated scattered collagen fibers in healing wounds or around dermal fillers.
The body wraps every foreign body or gel with a kind of granulation tissue, depending on the nature of its surface: the first cells are macrophages, which stimulate the formation of fibroblasts, which again fill-in the spaces with collagen fibers within the first few months. These scattered fibers are pure filling material secreted into to the intercellular matrix. As after healing of a wound, this natural filler disappears with the absorption of the foreign material. If it has fulfilled its purpose, why should the collagen fibers remain? The longevity of collagen is appealing but it is still an unproven marketing hypotheses of the manufacturers to convince doctors and patients.
In the dermal filler marketing strategy, they call this 'biostimulation' or 'neocollagenesis', however, there is no scientific proof for the existance of permanent collagen. The only histological "proof" of the Radiesse manufacturer at that time was their published picture of a clear Radiesse foreign body granuloma. Only permanent PMMA-microspheres are permanently surrounded by broad collagen bands. The microspheres made of polycaprolactone or polylactic acid stimulate just as little collagen as the calcium microspheres in Radiesse. The moment all dermal fillers are absorbed, the synthesis of collagen stops as well."
Isolated reports of persisting collagen after the dissipation of the collagen-triggering materials (Ellansé, Radiesse) need to be studied and supported from a scientific point of view.
As always, I thank Prof. Lemperle for his contribution to the sicence of soft tissue fillers, and especially for his invaluable and continuous support to me.
Best wishes!
DrC
Isolated reports of persisting collagen after the dissipation of the collagen-triggering materials (Ellansé, Radiesse) need to be studied and supported from a scientific point of view.
As always, I thank Prof. Lemperle for his contribution to the sicence of soft tissue fillers, and especially for his invaluable and continuous support to me.
Best wishes!
DrC
Category: General Phalloplasty Discussion