Handchir Mikrochir Plast Chir 2017; 49(06): 423-431
DOI: 10.1055/s-0043-112498
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Injizierbare Füllmaterialien – Update und Zukunftsperspektive

Soft tissue fillers: state of the art and future perspectives
Matthias M. Aitzetmüller
1   Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
,
Inesa Sukhova
1   Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
,
Georg M. Huemer
2   Sektion für Plastische, Ästhetische und Rekonstruktive Chirurgie, Johannes Kepler Universitätsklinikum, Linz, Österreich
,
Hans-Guenther Machens
1   Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
,
Jan-Thorsten Schantz
1   Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
,
Dominik Duscher
1   Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie, Klinikum rechts der Isar, Technische Universität, München, Deutschland
› Author Affiliations
Further Information

Publication History

03/02/2017

05/02/2017

Publication Date:
04 August 2017 (online)

Zusammenfassung

Neben der kosmetischen Verwendung kommen injizierbare Füllmaterialien auch im Bereich der plastisch-rekonstruktiven Therapie von Kontourdefekten am gesamten Körper zum Einsatz. Das ideale Füllmaterial sollte einfach zu injizieren und gut formbar sein, möglichst lange im Körper verweilen, weder allergen, kanzerogen noch anfällig für Infekte oder Biofilme sein, jedoch trotzdem potentiell reversibel, temperaturstabil und billig sein. Es gibt trotz eines großen Forschungsaufwandes in den letzten Jahrzehnten noch immer keinen Filler, der all diese Kriterien erfüllt. Mittlerweile ist eine breite Palette an Materialien, die unterschiedlichste Charakteristiken aufweisen, verfügbar. Hyaluronsäure, Kollagen (human oder bovin), Poly-Milchsäure (PLLA), Calcium-Hydroxyapatit (CaHA), Polymethylmethacrylat (PMMA), Silikon und Eigenfett sind zurzeit allesamt in klinischer Anwendung für verschiedenste Indikationen. Bei der Auswahl und Anwendung der Filler-Materialien muss zwischen Wirkdauer und Komplikationsrate abgewogen werden. Die Verwendung von permanenten Füllmaterialien geht mit einer erhöhten Rate an Nebenwirkungen wie Erytheme, Ödeme, Abszesse oder Ulzera einher. Die aktuellen Forschungsbemühungen auf industrieller und universitärer Ebene lassen einen Trend zugunsten der Entwicklung besser biokompatibler und trotzdem länger haltbarer Augmentationsmaterialien erkennen. Diese Übersichtsarbeit soll einen Überblick über die momentan gängigsten Filler-Materialien mit ihren Vor- und Nachteilen bieten und gleichzeitig neue potentiell erfolgreiche Ansätze beleuchten.

Abstract

In addition to cosmetic use, filler materials are frequently employed for reconstruction of contour defects. Scars and tissue defects after accidents, surgery and irradiation are also ideal indications for injectables. The ideal filler should be easy to inject, easy to form, and should remain in the body as long as possible. It should neither be allergenic or carcinogenic nor susceptible to infections or biofilms, but still potentially reversible, temperature-stable, and cheap. There is still no augmentation material that fulfils all of these criteria. A wide range of materials with widely varying characteristics is available on the market. Hyaluronic acid, collagen (human or bovine), polylactic acid (PLLA), calcium hydroxyapatite (CaHA), polymethylmethacrylate (PMMA), silicone and natural fat are all used in clinical practice for various indications. The current research efforts carried out at industrial institutions and universities are directed towards the development of augmentation materials with higher biocompatibility on the one hand and better durability on the other. In this review we provide an overview on filler materials currently used with their pros and cons. We further give an outlook on promising new approaches in the development pipeline.

 
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