Connective tissue augmentation

Taken together, the identification of mast cell hyperplasia and mediator release at sites of tissue fibrosis and wound healing, observations in animal models, and study of the actions of mast cell products, has provided much circumstantial evidence that mast cells are involved in tissue remodelling, healing and fibrosis. It is unlikely that mast cells are essential in these responses, but more likely that they augment them. Complex interactions between different connective tissue components, mast cells and other inflammatory cells are likely to operate, and are unlikely to be fully delineated in humans in vivo. It seems reasonable to hypothesize however that initial mast cell mediator release has the potential to activate fibroblasts, which may then promote the recruitment at d proliferation of further mast cells, explaining the mast cell hyperplasia often witnessed at sites of chronic inflammation. 

Concern about the use of silicone in implants and about its possible toxicity have come to public attention based on reports of a high prevalence of connective tissue disease associated with breast augmentation.Silicone appears to induce a response from polymorphonuclear cells and macrophages that bind small particles of silicone and transport them to lymph nodes, where they can accumulate. Other studies do not support a rheumatological role for sil-icone. Quantification of blood or tissue concentrations " correlates with the presence of implants but not with symptoms of joint disease. 

Hochberg MC Perlmutter DL (1996) The association of augmentation mammoplasty with connective tissue disease, including systemic sclerosis (scleroderma) a metaanalysis. CurrTop Microbiol Immunol, 210 411-417. 

It is important to note that correct injection technique is critical to the success of dermal augmentation. The location of the needle tip and the direction of the needle bevel must be carefully oriented so that gel particles are properly positioned in the dermal and subdermal connective tissues. Wrinkles and scars can be formed by collagen fiber systems that are attached to the dermal layer and pull it down into the softer connective tissue. The injected gel has to break or displace these connections to smooth the surface of skin. This depends, first of all, on the skill of the injector and second, on the quahty of the product and the structure of the skin of the patient at the site of injection. ... 

Process for augmenting connective mammalian tissue with in situ polymcrizible native collagen solution. 3,949,072 1976 Daniels and Knapp... 

Daniels, J.R. and Knapp, R. (1976) Process for augmenting connective mammalian tissue within situ polymerizable native collagen solution. US Patent 3, 949, 073. 

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