Soft Tissue Augmentation

Abstract

There has been a tremendous paradigm shift taking place in plastic surgery toward nonsurgical modalities in facial rejuvenation. This evolution accelerated over the last 5 years owing to the increasing demand from patients desiring less downtime and faster recovery. We have only begun to scratch the surface of what the future holds in less invasive techniques for not only the face but also the rest of the body. History has taught us to be cautious in rapidly introducing agents to fill facial defects. The search for that perfect filler would adequately fill the correct volume, be safe and biocompatible, nonteratogenic, noncarcinogenic, cause no infection, require no skin testing, and fully reversible. From the first filler agent, paraffin, to chemical agents in the early 1800s, to fat transplants in the late 1800s, the search for that perfect filler material was beginning to take shape. In the mid-twentieth century the advent of silicone changed the industry, only to be later banned due to its complications. The 1970s saw bovine collagen as the savior for facial augmentation. It ran a wonderful course until the game changer in 2006 when the FDA approved Hyaluronic acid fillers, which revolutionized the world of nonsurgical facial rejuvenation. Since then many different types of fillers have emerged on the market, and many more are on the horizon. More recently, PRP, or Plasma Rich Protein has taken the market by storm not only as filler, but also as a facial skin enhancer by attracting growth factors and stem cells.