Biomedical Engineering Reference
In-Depth Information
7.1.2 Modern Reconstructive and Aesthetic Plastic Surgery
Reconstructive surgery aims to improve the function and appearance
of abnormalities secondary to congenital defects,
t
rauma,
malignancies or burns [2].
Aesthetic, or cosmetic, surgery, on the other hand, is performed
to improve a patient's appearance using invasive or non-invasive
procedures. Invasive procedures are used, for example, to give a more
youthful appearance to the face or body, or to remove excess skin
after pregnancy, or significant weight loss. Non-invasive techniques
are used, for example, to treat pathologies of the skin, including
wrinkles, scars, pigmented spots, tattoos, and telangiectasias.
The most common non-invasive procedures performed to date
include botulinum toxin injections, filler injections, chemical peels,
cosmetics, lasers, and mesotherapy [1]. According to the statistics of
the American Society for Aesthetic Plastic Surgery (ASAPS), there was
a 10% increase in non-surgical procedures in 2012. HA injections
were the second most popular treatment among them.
7.2 Hyaluronic Acid
HA was first described by Karl Meyer, the father of glycosaminoglycan
(GAG) chemistry [2]. It was further developed by Endre Balazs who
established methods to produce and apply the molecule in medicine
[3].
It is one of the major elements of the connective tissue in both
human and mammals, and it is present in the extracellular matrix
(ECM) of the skin and muscles, and in high concentrations in the
vitreous body of the eye, and in the joints [4]. In the skin, its main
function is conservation of volume and tone. It gradually diminishes
with age, leading to the progressive formation of wrinkles and skin
imperfections.
Chemically, HA is an anionic, unsulfated GAG. Its main compo-
nent is a non-branched chain polysaccharide composed of
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