Reconstructive and Aesthetic Surgery

Reconstructive surgery aims to improve the function and appearance of abnormalities secondary to congenital defects, trauma, malignancies or burns [2]. 

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 

It is one of the major elements of the connective tissue in both human and mammals, and it is present in the extracellular matrix (EGM) 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 component is a non-branched chain polysaccharide composed of 

The half-life of HA ranges from 12-24 h in both the dermis and the epidermis. The presence of HA in epithelial tissues promotes keratinocyte proliferation and increases the presence of retinoic acid, causing skin hydration. HA interaction with CD44 antigen drives collagen synthesis and normal skin frmction. Present in the ECM of basal keratinocytes, HA is critical to the structural integrity of the dermal collagen matrix. 

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Rubin, J. P. et al.. Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery a comprehensive review of the literature. Blast. Reconstr. Surg., 100, 1336, 1997. 

Kovacs, L., A. Zimmennann, G. Brockmann, M. Guhring, H. Baurecht et al. (2006). Three-dimensional recording of the human face with a 3D laser scaimer. Journal of Plastic, Reconstructive and Aesthetic Surgery 59 1193-202. 

Kalbermatten, D.F., et al. 2008. Fibrin matrix for suspension of regenerative cells In an artificial nerve conduit. Journal of Plastic, Reconstructive and Aesthetic Surgery 61(6) 669-675. 

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