gold thread zŁote nici skin tenser body filler implant

GOLD THREADGOLD THREADZŁOTE NICIZŁOTE NICI

Skin tenserSkin tenser

Body filler implantBody filler implant

TOPICS FOR DEVELOPMENT:TOPICS FOR DEVELOPMENT: Historical backgroundHistorical background

Mechanism of actionMechanism of action

IndicationsIndications

Preoperative phasePreoperative phase

TechniqueTechnique

Postoperative phasePostoperative phase

ComplicationsComplications

AdvantagesAdvantages

ConclusionsConclusions

HISTORICAL BACKGROUNDHISTORICAL BACKGROUND Ancient Egypt: threads of pure goldAncient Egypt: threads of pure gold 1960s: Caux , subdermal gold threads in facial 1960s: Caux , subdermal gold threads in facial

surfacesurface 1970s: J.Conley and D.Baker, implantation of the 1970s: J.Conley and D.Baker, implantation of the

thread under (and adapting to) the wrinklethread under (and adapting to) the wrinkle 1992 : D.Orenes (gold + catgut), vertical and 1992 : D.Orenes (gold + catgut), vertical and

horizontal implantation horizontal implantation 1992 : application kit (Lorca Marin, S.A.), 1992 : application kit (Lorca Marin, S.A.),

combining gold thread with simple catgutcombining gold thread with simple catgut

MECHANISM OF ACTIONMECHANISM OF ACTIONGOLD THREAD:GOLD THREAD: Produces a granulomatous reaction characterized by Produces a granulomatous reaction characterized by

the appearance of abundant elastic fibres around the the appearance of abundant elastic fibres around the implant, together with neovascularization of the implant, together with neovascularization of the implant zone. This affords skin youthening in the implant zone. This affords skin youthening in the implant zone.implant zone.

POLYGLYCOLIC ACID: POLYGLYCOLIC ACID: Produces minimum acute tissue inflammation, Produces minimum acute tissue inflammation, followed by gradual encapsulation by the connective followed by gradual encapsulation by the connective tissue. Posteriorly, gradual tension strength is lost, tissue. Posteriorly, gradual tension strength is lost, with hydrolysis-mediated absorption that is completed with hydrolysis-mediated absorption that is completed within 60-90 days after implantation.within 60-90 days after implantation.

MECHANISM OF ACTION MECHANISM OF ACTION

Gold + PGAGold + PGA PVDFPVDF180 180 daysdays

- Collagen fibers are - Collagen fibers are observed in the adipose observed in the adipose cellular structure, i.e., cellular structure, i.e., collagen formation has collagen formation has extended beyond the extended beyond the capsule limits.capsule limits.

- The structure is - The structure is completely surrounded by completely surrounded by newly formed blood newly formed blood vessels.vessels.

- A significant presence - A significant presence of mast cells is observed.of mast cells is observed.

-The thread is surrounded by a The thread is surrounded by a capsule composed of collagen capsule composed of collagen bundles.bundles.-- The presence of mast cells is - The presence of mast cells is nonsignificant.nonsignificant.

INDICATIONS:INDICATIONS:

IIncipient agingncipient aging

Elimination of flabbinessElimination of flabbiness

Filling of grooves and wrinklesFilling of grooves and wrinkles

The correction of facial wrinkles is one of the main The correction of facial wrinkles is one of the main challenges in esthetic surgery and exerts a negative challenges in esthetic surgery and exerts a negative psychological and emotional effect upon patients.psychological and emotional effect upon patients.

The existing surgical methods are traumatic and The existing surgical methods are traumatic and imply the need for anesthesia and postoperative imply the need for anesthesia and postoperative period.period.

Our aim is therefore to increase efficacy in combating Our aim is therefore to increase efficacy in combating and preventing involutional changes through “skin and preventing involutional changes through “skin firming with special surgical threads”.firming with special surgical threads”.

• SKINGOLD is a filler implant developed by SKINGOLD is a filler implant developed by LORCA MARÍN for the prevention of face LORCA MARÍN for the prevention of face and neck ptosis, and flabbiness of the inner and neck ptosis, and flabbiness of the inner arm and thigh skin surfaces.arm and thigh skin surfaces.• SKINGOLD can also be used to correct neck SKINGOLD can also be used to correct neck and face wrinkles.and face wrinkles.• SKINGOLD is applied by means of a simple SKINGOLD is applied by means of a simple “ambulatory surgery” technique.“ambulatory surgery” technique.• SKINGOLD has no adverse effects. SKINGOLD has no adverse effects.

•

SKINGOLD – Gold ThreadSKINGOLD – Gold Thread

• SKINGOLD affords evident results within one month.SKINGOLD affords evident results within one month.• SKINGOLD maintains the visible effects for more than 5 years.SKINGOLD maintains the visible effects for more than 5 years.• SKINGOLD is CE certified.SKINGOLD is CE certified.• SKINGOLD is a registered trademark of LORCA MARÍN. SKINGOLD is a registered trademark of LORCA MARÍN.

Case historyCase history Treatment: analgesic - Treatment: analgesic -

antiinflammatory, antiinflammatory, antibioticantibiotic

Informed consentInformed consent Preoperative Preoperative

photographsphotographs

PREOPERATIVE PHASE :PREOPERATIVE PHASE :

TECHNIQUE :TECHNIQUE :

MarkingMarking

• MarkingMarking

Preparation of the surgical field, with strict asepsis.Preparation of the surgical field, with strict asepsis. Anesthesia:Anesthesia:

o either topical (EMLA° type cream)either topical (EMLA° type cream)o or local subdermal infiltration at entry and exit pointsor local subdermal infiltration at entry and exit points

10-15 ml lidocaine 2%10-15 ml lidocaine 2% 0,1 ml adrenalin 1%°0,1 ml adrenalin 1%° 25G 5/8 or 30G ½ needle25G 5/8 or 30G ½ needle

Subdermal implantation of the gold thread (accordion Subdermal implantation of the gold thread (accordion effect)effect)

CompressionCompression Immobilization? (micropore° dressing)Immobilization? (micropore° dressing)

TECHNIQUE :TECHNIQUE :

POSTOPERATIVE PHASEPOSTOPERATIVE PHASE

Local application of iceLocal application of ice

Antibiotics (oral and topical)Antibiotics (oral and topical)

Immobilization (avoid facial gestures, Immobilization (avoid facial gestures, micropore*)micropore*)

Control after one week Control after one week

Hematomas – ecchymosisHematomas – ecchymosis

Infection Infection

Cords (superficial, granuloma)Cords (superficial, granuloma)

ExtrusionExtrusion

Asymmetries - DimplesAsymmetries - Dimples

COMPLICATIONSCOMPLICATIONS

ADVANTAGESADVANTAGES

Rapid return to social and labor activityRapid return to social and labor activity

Important youtheningImportant youthening

WITHOUT scarsWITHOUT scars

NO painNO pain

Experimental clinical group – A. V. Experimental clinical group – A. V. Vishnevski Surgical Institute( Moscow).Vishnevski Surgical Institute( Moscow).

These investigators conduced comparative These investigators conduced comparative and experimental studies with implants of and experimental studies with implants of gold thread + PGA and Trofilene ( PVDF ) in gold thread + PGA and Trofilene ( PVDF ) in 300 patients.300 patients.

Study of the mechanism of action of gold Study of the mechanism of action of gold thread (morphological changes).thread (morphological changes).

TESTS CARRIED OUTTESTS CARRIED OUT

Clinical observations: correction of Clinical observations: correction of involutional changes in face and neck.involutional changes in face and neck.

Immediate and long-term effects.Immediate and long-term effects.

Assessment of blood flow in the tissues Assessment of blood flow in the tissues surrounding the implant (SRSV).surrounding the implant (SRSV).

Evaluation of surrounding tissues.Evaluation of surrounding tissues.

Tissue microcirculation.Tissue microcirculation.

TESTS CARRIED OUTTESTS CARRIED OUT

CONCLUSIONS 1.- Before treating the patient with this technique,

evaluation is required of tissue condition – objectively establishing the involutional grade and defining the choice of technique for firming, in order to be able to predict the outcome.

2.- The morphological changes around the implant are characterized by: functional activity of the fibroblasts, collagen production and increased capillaries.

3.- The procedure increases the microcirculation

indexes between 44-53%, thus favoring nutrition in the area.

4.- firming can be applied as prophylaxis (grade I cases) and as corrective measure (grades II, III and IV).

5.- In grade I and II cases, the technique is effective as an independent method (75% good results).

6.- In firming of the infraorbital zone, implants should also be placed in the malar region and temples – with implants in the rest of the face on a unified basis.

7.- In grade III cases it is advisable to implant supplementary threads in the oval facial zone.

.

8.- In grade IV cases it is advisable to combine the procedure with surgical corrective measures (liposuction and ritidectomy / face lift).

9.- No leakage is observed after implantation of over 0,5 cm in young patients.

10.- In patients over 56 years of age, leakage of tumor-like appearance is observed, with local inflammation.

GOLD THREAD KIT / SKINGOLDGOLD THREAD KIT / SKINGOLD

Ready to use (gold + PGA), 25 cm length, boxes with Ready to use (gold + PGA), 25 cm length, boxes with 12 U 12 U

Triangular straight, atraumatic needle (60 mm length)Triangular straight, atraumatic needle (60 mm length) Gold thread (24 kt 99,99% purity) 0,1 mm diameterGold thread (24 kt 99,99% purity) 0,1 mm diameter Colorless polyglycolic acid thread (caliber 3/0 USP)Colorless polyglycolic acid thread (caliber 3/0 USP) Sterile (EO)Sterile (EO) Histocompatible.Histocompatible.

PHOTOGRAPHS OF CASES:PHOTOGRAPHS OF CASES:

BeforeBefore AfterAfter

THANK YOU VERY MUCHTHANK YOU VERY MUCHTHE ENDTHE END

IQ MEDICAIQ MEDICATel. (+48 22) 465-68-00Tel. (+48 22) [email protected]@iqmedica.com

gold thread zŁote nici skin tenser body filler implant

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