Morphological foundations of facelift using APTOS filaments（1）
A.A. Adamyan, M.A. Sulamanidze, N.D. Skuba, Z.R. Khusnutdinova
A. V. Vishnevsky Institute of Surgery, Russian Academy of Medical Sciences, Moscow, Russia
（www.nutecint.com/Docs/Aptos%20article.doc）
Introduction
Correction of earlier involutional changes of the face, in the first place facial skin ptosis, encounters some difficulties. On the one hand, these changes are not serious enough to serve as an indication for radical aesthetic surgery. On the other hand, traditional minor surgical interventions fail to ensure well-apparent beneficial effect.
Moreover, many women are reluctant to undergo extensive surgery since it entails prolonged rehabilitation which may sometimes take one and a half months to be completed.
No wonder, many plastic surgeons tend to resort to a combination of minor invasive interventions that are apt to significantly shorten the rehabilitation period and are possible to perform in an outpatient setting.
Materials and methods
Recent years witnessed wide implementation into clinical practice of aesthetic surgery of an effective, Atraumatic method of treatment of facial involutional alterations – Lifting of the soft tissues with the help of the specially designed “APTOS” threads(1, 4, 5, 6, 7, 8 ).
The method is based on the use of specially designed Polypropylene APTOS filaments and recommended for managing Moderate involutional changes in the facial soft tissues and Local face lifting. One side of an APTOS thread bears barbs that extend forward in the direction of its movement through the tissue, on the other side the barbs extend backward, i.e. in the opposite direction. Such a design ensures that the filament gently glides through soft tissues in a desired direction but resists drawing in the opposite one, i.e. remains fixed as appropriate. As a result, subcutaneously implanted filaments keep in place the lifted facial tissues uniformly drawn into puckers, do not allow them to slip down, and thus maintain a new facial contour.
However, until now it remains unknown how the APTOS threads behave within the tissues in time and what are the local and morphological processes maintaining the tension and creating the rejuvenating effect.
In an attempt to clarify the mechanism of tissue reactions to subcutaneous implantation of APTOS filaments, an experimental study of the resulting morphological changes was undertaken at the A.V. Vishnevsky Institute of Surgery. A group of 20 white rats was used as a model from which 72 tissue samples were obtained for histological studies. Morphological findings were compared with the results of examination of tissue samples following implantation of smooth polypropylene filaments to another group of animals that served as control.
The material for histological analysis included implants, their capsules, and the surrounding tissues.
Relative vascular bed density（RVBD）at different time intervals after implantation was estimated and compared with RVBD of intact rats to evaluate changes of blood supply to the tissues surrounding implanted polypropylene filaments.
Relative vascular bed density was calculated by the following standard formula：
Number of points in the blood vessel field
RVBD = --------------------------------------------------------- x 100%
Total number of points in the examined field
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