Dermal filling

When discussing treatment possibilities for acne scars with a would-be patient, the doctor should be extremely cautious. Skin that is very scarred can, however, be completely renewed, evened out and smoothed using a combination of treatments such as subcision, dermal filling, dermabrasion, punch excision, punch elevation, possibly micro skin grafts or even injections of cultured stem cells or fibroblasts (Isolagen). 

Although the epidermis regenerates readily over an intact or partly intact dermal bed, it is well-known that de novo synthesis of the dermis does not occur spontaneously [65, 66], Likewise, even though the rat sciatic nerve is regenerated spontaneously across a 5-mm gap or occasionally across a 10-mm gap (provided that the cut ends of the nerve are inserted in a saline-filled rubber tube), no such regeneration is spontaneously observed across a 15-mm gap [67,68]. The appropriate use of collagen-GAG matrices leads to synthesis both of skin, complete with dermis and epidermis [79, 80, 84] and of new sciatic nerve [83]. It is this ability to induce de novo synthesis of nearly physiological tissue... 

Rayner et al. 1972 Richter et al. 1992 Soliman et al. 1982 Stalberg et al. 1978), no comparative animal studies are available. There is a correlation in the data regarding the absorption, distribution, metabolism, and excretion of diazinon following oral doses in both animal and human studies (Abdelsalam and Ford 1986 Iverson et al. 1975 Janes et al. 1973 Machin et al. 1971, 1974 Mount 1984 Miicke et al. 1970 Poklis et al. 1980) however, comparative data on the distribution and metabolism of diazinon after inhalation or dermal exposure in humans or animals, or on the excretion of diazinon after dermal exposure in animals are not available. Further studies are required to fill these data gaps. 

The large volume occupied by high molecular size HA chains, including the aqueous solvent volume underlies the ability to distend and maintain extracellular spaces and tissue hydration. In fact, the moisture of skin is attributed to the rich HA content of the dermal compartment. For example, HA is present in significant amounts in hyaline cartilages, enough to fill the tissue volume in the absence of other constituents. Therefore, HA has been assigned various roles in the homeostasis of the extracellular space [17]. 

FIGURE 1 Cellular and tissue alterations induced by HD that are proposed to result in blister formation. HD can have many direct effects, such as alkylation of proteins and membrane components (Memb), as well as activation of inflammatory cells. One of the main macromolecular targets is DNA, with subsequent activation of poly(ADP-ribose) polymerase (PARP). Activation of PARP can initiate a series of metabolic changes culminating in protease activation. Within the tissue, the penultimate event is the epidermal-dermal separation that occurs in the lamina lucida of the basement membrane zone. Accompanied by a major inflammatory response and changes in the tissue hydrodynamics (Hyd), fluid fills the cavity formed at this cleavage plane and presents as a blister. 

Filling techniques can also be used immediately before ETCA, as the ETCA post-peel cream soon stops inflammation and oxidation. The cream can also absorb the free radicals that are released by the peel and that could damage the three-dimensional structure of dermal fillers, such as hyaluronic acid. In fact, the instructions for most dermal filler products specify not to apply a peel after the filler, but... 

Choking Agents injure an unprotected person chiefly in the respiratory tract. In extreme cases, membranes swell, lungs become filled with liquid (pulmonary edema), and death results from lack of oxygen. Some agents may also pose a dermal hazard. 

---