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Morphological foundations of facelift using APTOS filaments（5）

To summarize the results of comparative histological study of the soft tissues surrounding implanted filaments, the following conclusions can be drawn：

• Collagen biosynthesis begins earlier and ends later after the implantation of APTOS filaments than after the implantation of smooth polypropylene threads; moreover, it is more extensive and involves a greater tissue volume in the former case.

• Fibrous capsule around the filament Shaft and Barbs gives rise to connective tissue Bands that extend towards Epidermis and Subcutaneous fatty layer and merge with connective tissue fibres of these tissues.

• Tissues surrounding APTOS filaments contain much more microvessels than tissues enclosing smooth threadswhere the microcirculatory system extends but insignificant TyT.

• Microvessels formed after the implantation of APTOS filaments have an open lumen. This feature referred to as «phenomenon of persistent hyperemia» can be seen at any time after the implantation, unlike the case of smooth polypropylene threads when hyperemia occurs only in the early postimplantation period.

• Barbs of APTOS filaments are enclosed in their own connective tissue Capsule having significantly Thicker walls than the capsule around the shaft of the filament. This great­ly contributes to Solid fixation of APTOS filaments in the sur­rounding tissues.

• A Capsule around the Barbs is less mature than around the shaft of the filament. This suggests a stronger Stimula­tory effect of the Barbs on the surrounding tissues which in turn accounts for prolonged Collagen biosynthesis and thus promotes Fixation of both the filaments and the lifted tis­sues.

• Tissues surrounding APTOS filaments contain Mast cells, the number of which remains virtually constant throughout the post-implantation period. These cells con­tribute to Vasodilation in the microcirculatory system and Transportation of Hyaluronic acid to the tissues around the filaments. The number of mast cells in the tissues surround­ing smooth polypropylene threads is signiicantly smaller.

• Implantation of APTOS filaments induces no phagocytic reaction.

• The relative microvascular bed area increases by 26% after the implantation of APTOS filaments leading to a marked improvement of local tissue oxygenaion and blood supply. Implantation of smooth polypropylene threads causes a much smaller increase of relative vascular bed density.

REFERENCES

1. Adamyan A.A., Skuba N.D., Sulamanidze M.A., Khusnutdinova Z.R. “Morphological substantiation of facial skin lifting with APTOS threads” International Congress on Plastic, Reconstructive and Aesthetic Surgery, Abstracts of Papers, Moscow., 2002, p. 9 – 10.

2. Avtandilov G.G. Fundamentals of pathoanatomical practice, Moscow, «RMAPO», 1998, 505 p.

3. Bykov V.L. Cell biology and general histology, St. Petersburg, - “Sotis”, 1998, 364 p.

4. Sulamanidze M.A., M.D., Fournier P.F., M.D., Paikidze T.G., M.D., Sulamanidze G.M., M.D. Removal of Facial Soft Tissue Ptosis With Special Threads. DERMATOLOGIC SURGERY, Vol. 28 No. 5, May 2002.

5.  Sulamanidze M., Paicidze T., Sulamanidze G. Utilisation du fil “APTOS” dans le lifting facial. La revue de chirurgie esthetique de langue Francaise. T. XXV, N103, may 2001, Pp. 17-22.

6. Sulamanidze M., Paicidze T., Sulamanidze G. Lifting facial con hilos APTOS. International Journal of Cosmetic Medicine & Surgery. Volumen 3 Numero 3. Diciembre 2001, Pp. 139-142.

7.  Fournier F.P. Reflexions sur les fils tuteurs APTOS de Sulamanidze. La revue de chirurgie esthetique de langue Francaise. T. XXV, N104, septembre 2001, Pp. 23-27.

8. Fournier F.P. Fils et fillings. La revue de chirurgie esthetique de langue Francaise. T. XXV, N105, decembre 2001, Pp. 3-6.