Sage Journals: Discover world-class research

Abstract

Introduction:

Previous studies of expanded polytetrafluoroethylene (ePTFE) soft tissue implants using subjective measurements have indicated problems with implant hardening, contraction, and loss of efficacy over time. However, clinical studies using objective measures have not yet been published in the evaluation of these implants. This study aims to evaluate lip ePTFE implants prospectively with objective evaluation of changes in implant hardness and length, lip projection, and vermilion show over time.

Methods:

Patients with atrophic lips were enrolled in this study. Thin-walled tubes of ePTFE were implanted into upper or lower lips. Lip projection and vermilion show were measured using lateral digital images and digital software. Lip hardness was measured using a durometer, a hand-held device designed to register the hardness of various substances using a spring-loaded indentor. All measurements were completed preoperatively and postoperatively at days 15, 30, 90, and 180. Preoperative measurements served as control data. All measurements from preoperative and additional time-point values were compared using at test.

Results:

A total of 19 implants were placed in 10 patients. One implant was removed due to patient dissatisfaction with overprojection, another was removed for acute infection. One implant/patient was lost to follow-up. Durometer scores of the lip increased nearly fourfold, which indicates an increase in hardness over time (P < .001). Gains in lip projection peaked at 2 mm by 3 months postoperatively and returned to within 1 mm of baseline by 6 months. No implant shortening occurred.

Discussion:

Tubular ePTFE implants were safe and resulted in modest gains in lip projection over 6 months. However, these implants lost initial gains in projection and hardened over time, with loss of vermilion show in some cases. These changes over time may be due to a process similar to the capsular contracture commonly seen with breast implants.

Get full access to this article

View all access options for this article.

References

Barrett

. No Time for Any Wrinkles. Newsweek Magazine. May 17, 2004:42–44.

Constantino

. Synthetic materials for soft-tissue augmentation and replacement in the head and neck. Otolaryngol Clin N A. 1994;27:223–261.

Denton

Maas

. Synthetic soft tissue substitutes 2001. FPS Clinics of North Am. 2001;9:219–227.

Maas

Erickson

McCalmont

, Evaluation of ePTFE as a soft-tissue filling substance: An analysis of design-related implant behavior using the porcine model. Plast Reconstr Surg. 1998;101:1307–1305.

Wall

Adamson

Bailey

van Nostrand

. Patient satisfaction with ePTFE (Softform) implants to the perioral region. Arch Fac Plast Surg. 1998;5:320–324.

Stupak

Ramirez

Maas

. A retrospective analysis of the long-term effects of the Softform ePTFE facial implant. Presentation at the 8th International symposium of Facial Plastic Surgery; May 3, 2002.

Castor

Papay

. Lip augmentation with AlloDerm acellular allogenic dermal graft and fat autograft: A comparison with autologous fat injection alone. Aesthetic Plast Surg. 1999;23:218–223.

Falanga

Bucalo

. Use of a durometer to assess skin hardness. J Am Acad Dermatol. 1993;29:47–51.

Syger

van den Hoogen

de Boo

, Low-dose methotrexate in the treatment of widespread morphea. J Am Acad Dermatol. 1998;39(2 pt 1):220–225.

10.

LeBlanc

Falabella

Murata

, Durometer measurements of skin induration in venous disease. Dermatol Surg. 1997;23:285–287.

11.

Romanelli

Falanga

. Use of a durometer to measure the degree of skin induration in lipodermatosclerosis. J Am Acad Dermatol. 1995;32(2pt 1):188–191.

12.

Byrne

Hilger

. Lip augmentation. Facial Plast Surg. 2004;20:31–38.

13.

Embrey

Adams

Cunningham

, A review of the literature on the etiology of capsular contracture and a pilot study to determine the outcome of capsular contracture interventions. Aesthetic Plast Surg. 1999;23:197–206.

14.

Hakelius

Ohlsen

. A clinical comparison of the tendency to capsular contracture between smooth and textured gel-filled silicone mammary implants. Plast Reconstr Surg. 1992;90:247–254.

A Prospective Study of Tubed ePTFE Lip Implants: An Objective Evaluation of Efficacy,Hardness,and Length

Abstract

Introduction:

Methods:

Results:

Discussion:

Get full access to this article

References