Dermalive

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Dermadeep Neues Konzept der Augmentation am
Anfang des 21. Jahrhunderts
?
GÄCD 2004
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AGE Control
Altern gehört zum Leben, die Frage ist nur, wie
sehr es einem schadet.
Hyaluronic Acid
Dr. med. M. E. Cornely Düsseldorf Wagnerstrasse
Dr. Harrer, Nürnberg
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Hollow cheeks with Dermadeep
Before treatment
After injection
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Soft-tissue fillers main injectable products
available on the market
gt Resorbable
gt Non-resorbable

• Collagen
• Hyaluronic acid
• Autologous fat
• Polylactic acid

• Silicone
• PMMA (collagen) Artecoll
• Acrylic Hydrogel (hyaluronic acid)
• Dermalive Dermadeep
• Poly-acrylamid

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Dermadeep

• Biphasic implants

• Acrylic hydrogel (40)
• Non resorbable material
• Hyaluronic acid (60)
• Biodegradable injection vector

Suspension of flexible and non-resorbable
fragments of Acrylic Hydrogel in a sterile
non-pyrogenic and physiological solution of
slightly cross-linked Hyaluronic Acid of
non-animal origin.
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Acrylic Hydrogel

• Belongs to the Acrylate family
• Inert and elastic non-resorbable material,
  renowned for its high biocompatibility
• Its name "hydrogel" is derived from its high
  water content (26) which is stable in the
  long-term (the water molecules are trapped inside
  the acrylic hydrogel molecules).
• Particles are flexible, elastic and resistant
  (elongation of 400 before breaking)

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Indications of Dermadeep remodelling facial
contours

• Filling very pronounced nasolabial folds
• Restoring volume to the cheeks and cheekbones
• Remodelling the chin contour
• Improving final outcome of Facelift

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Placement of Dermadeep
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Nasolabial folds with Dermadeep
Before treatment
After injection
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Clinical resultsDr. Harrer, Nürnberg

• Treated areas(2)
• Nasolabial folds 45
• Lips (contouring and perioral) 21
• Glabellar lines 13
• Cheeks and cheekbones augmentation 12
• Scars 8
• Chin folds 1
• 2 Total is gt100 as several areas may have been
  treated simultaneously

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Clinical resultsDr. Harrer, Nürnberg

• Efficiency of the implant after 6 years
• ? In 96 of the cases, patients were satisfied
• with the results.
• ? 4 of the patients were dissatisfied or
• considered the results to be unsufficient.

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Clinical resultsDr. Harrer, Nürnberg

• A clinical study conducted in 1440 patients
  during more than 6 years has shown the very good
  tolerance and the efficiency of Dermalive
  Dermadeep.
• A total of 1630 syringes of Dermalive or
  Dermadeep has been injected (on average 1-2
  syringes per patient).
• Complications only 6 out of 1440 patients
  developed inflammatory granuloma

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Clinical results

• Long-term side-effects
• Since 1998, no necrosis, no immediate
  hypersensitivity reaction and no case of allergy
  or implant migration have been reported.

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DERMADEEP 80-120 microns
In the INFANCY of FILLER TECHNOLOGY, SEMIPERMANENT
FILLERS HAVE BEEN ASSOCIATED WITHNUMEROUS
COMPLICATIONS eg granulomas, nodules

• microparticles larger than 40 microns have a
  lower chance of being phagocytised and therefore
• less likely to initiate an inflammatory reaction
  when injected into the dermis and subdermis as a
  filler substance

Morhenn, Lemperle and Gallo Phagocytosis of
different particulate Dermal Filler Substances by
human macrophages and skin cells. Dermatol Surg
200228484-490
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DERMADEEP
40 Hydroxyethyl methacrylate (HEMA)
microfragments 80-120 microns in size with 60
crosslinked hyaluronic acid of bacteriological
origin
WOFFLES WU MD CAMDEN MEDICAL CENTRE SINGAPORE
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6 Midface Hollow Zones - Wu
Number of patients
Zone 1 - medial infraorb rim 66
Zone 2 - middle infraorb rim 125
Zone 3 - lat infraorbital rim 178
1
3
2
6
Zone 4 - Infraorbital hollow 582
4
5
Zone 5 - submalar hollow 222
Zone 6 - Malar highlight 57
Nasolabial grooves 601
Chin 129
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complications

• Complaints of visible swelling, palpable
  lumpiness in
• 10/683 0.00826
• 9 in NJG (8 within 1month, 1 after 2 years)
• 1 in NLG, (clinically unable to detect by
  physician)
• all resolved with Kanakort injections
• No redness at injections sites
• No infection
• No persistent granulomas
• No migration

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THE IDEAL FILLER

• Particulate, biocompatible material
• Chemically inert
• No migration, non liquid
• Complete encapsulation and incorporation into the
  tissues
• Minimal inflammation, No granuloma formation
• Easy to inject
• Long lasting NATURAL feel

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gt Dermalive

• With a five-year follow-up, a global complication
  rate of less than
• 2 per 1,000 (0.2) has been recorded for
  Dermalive.
• In most of these reported cases, this was due to
  a misuse of the
• product or a non-respect of the
  contraindications.
• Observed complications appear as nodules, oedema
  and
• induration at the injection site after six months
  in average.
• Early medical treatment in the form of
  intralesional injections
• (corticoids, 5FU) have been reported to be
  successful.

gt Dermadeep
On 10,000 patients treated with Dermadeep, only
two side-effects have been reported to Dermatech
(4 year follow-up).
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Contraindications

• Linked to the injection site
• - Not to be injected in the Dermis
• - Not for periorbital zone, forehead wrinkles,
  glabellar frown lines and lips and superficial
  wrinkles
• - Avoid site where another implant is already
  present
• - Not to be used in association with laser,
  chemical peeling or dermabrasion
• Linked to the individual patient
• - Tendency to develop hypertrophic scars
• - History of autoimmune disease or under
  immunotherapy treatment
• - Tendency to develop inflammatory and/or
  infectious skin problems
• - Multiple allergies
• - Known hypersensitivity to sodium hyaluronate

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Clinical Results

• Results of independent clinical studies have
  confirmed the very good tolerance, the safety and
  the efficiency of Dermadeep.
• After 4 years of use, no necrosis, no immediate
  hypersensitivity reaction
• and no case of allergy or implant migration have
  been reported.
• However,
• the occurrence of an adverse reaction several
  months or years after the injection is possible
• with all implants (resorbable or non-resorbable),
  
• i.e. inflammatory granuloma or delayed
  hypersensitivity.

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Available since 1999, Dermadeep has been
already used successfully for treating more than
10,000 patients worldwide and has proven to be
safe and efficient for soft-tissue
augmentation. With a four-year follow-up,
only two side-effects have been reported to
us.
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1. Never without clarification about the risks
2. Never transmuscular 3. Never inject
under surgery 4. Fillers only in the hands of
medical professionals

• Disinfection the area to be injected
• Dermadeep has to be slowly injected into the
  epiperiostal layer or the hypodermis by using the
  linear withdrawing or criss-cross technique, in
  order to create a volume in the desired area by
  accumulating fragments of Acrylic Hydrogel
• In any case, it must not be injected into the
  dermis!!!

• Do not overcorrect
• After the injection, massage the treated area for
  an even distribution and a perfect integration of
  the particles into the surrounding tissue
• Respect a minimum 3 month period between two
  injection sessions

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Hollow cheeks with Dermadeep
Before treatment
After injection