What’s new in cosmetic surgery?

New cosmetic surgery techniques will continue to be developed and expanded as demand grows. Procedures such as facelifts, which were traditionally performed with scalpels, may in the future be done with lasers. Recovery times will be quicker and scarring will be less.

The possibilities in plastic and cosmetic surgery are endless. Tissue engineering is no longer something out of a science fiction novel. The creation of living tissues in a laboratory setting for use as a replacement for damaged or diseased body parts is already on the horizon.

The growing and reproduction of skin grafts, breast tissue, muscles, cells from vital organs and even nerves lie just ahead in the medical future. And though the science is still in its infancy, there is no doubt that the future of cosmetic and reconstructive surgery will likely have tissue engineering at its core.

What are the types of cosmetic surgeries?

Collagen injections: Used in Europe since 1989, Artecoll® (available as Bellafil® in the United States) was the first permanent injection to treat wrinkles. Microscopic plastic beads suspended in bovine collagen are injected into the area needing treatment. Once the body absorbs the injected collagen, the tiny beads stimulate the body to produce its own collagen, spurring a permanent cycle of collagen production. Every time the collagen depletes, the beads tell the body to produce more. Patients must be tested for allergies to collagen prior to this procedure. The results are long-lasting and show improvement for 3 or more years.

The technology for Cosmoderm® and Cosmoplast® uses the fibroblasts (collagen-producing cells) found in the discarded foreskins of infant boys after circumcision. The fibroblasts are isolated and then replicated to produce the collagen needed for injection. Like bovine collagen which had been commonly used to treat wrinkles, these products eventually are reabsorbed by the body and require another treatment 3-6 months later. Unlike bovine collagen, Cosmoderm® and Cosmoplast® – used to treat fine lines and deep wrinkles respectively – does not require that the patient be tested for allergies to the collagen. Cosmoderm® and Cosmoplast® were both approved by the Food and Drug Administration (FDA) for use in 2003.

Botulinum toxins: For some people Botox® is not strong enough, does not last long enough, or may simply not be an option due to their bodies’ natural resistance to the botulinum toxin. For these people, other forms of botulinum toxin may benefit people who are resistant to Botox®. Like Botox®, Dysport® is also a botulinum toxin type A but it is a larger dose than Botox (units are different, not directly comparative). Patients treated with Dysport® may require fewer treatments per year than those treated with Botox®. Since 2009, the FDA has approved Dysport® to treat forehead wrinkles and frown lines. Botulinum toxin type B or Myobloc® also has a dosage larger than Botox®, but its effects are more immediate. Both products carry the same risk of allergic reaction as does Botox®.

Hyaluronic acid: This is a natural component of skin tissue that provides cushioning and lubrication. In the US, the FDA has approved many hyaluronic acid fillers (brand names include Belotero®, Restylane®, and Juvederm®) for treatment of facial wrinkles and folds and lip rejuvenation.

Radiesse®: Derived from calcium hydroxylapatite, a substance found in human bones and teeth, Radiesse® is an injectable paste used to enlarge the lips and fill folds and lines. The effects are reported to last for 2-5 years. Since Radiesse® is derived from human tissue, there is little chance of allergic reaction. As of December 2006, the FDA approved Radiesse ® for the long-lasting correction of moderate to severe facial wrinkles and folds such as nasolabial folds and for injection into the dorsal hands. Radiesse® also received another FDA approval for the long-lasting correction of facial fat loss (lipoatrophy) in people with human immunodeficiency virus (HIV).

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