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JAMA Facial Plastic Surgery Classics
Jan/Feb 2014

What We Have Learned About Soft-Tissue Augmentation Over the Past 10 Years

Author Affiliations
  • 1The New York Eye & Ear Infirmary, New York
  • 2New York Medical College, Valhalla
JAMA Facial Plast Surg. 2014;16(1):64-65. doi:10.1001/jamafacial.2013.1379

In 2002, my coauthors and I published the results of a clinical trial of micronized acellular dermal graft (mADG) (Cymetra; Lifecell Corp) for rejuvenation of the aging lip.1A look back at this article is instructive as to where we were, as a field, at the beginning of the millennium and allows reflection on where we are headed.

In this study, we evaluated mADG for use as an injectable agent to augment lips. At the time of the study, the criterion standard material was Zyplast (glutaraldehyde cross-linked porcine collagen; Allergan Inc), which, on average, required retreatment on a quarterly basis. Furthermore, there were no accepted, validated instruments to assess lip appearance. In our study, patients were randomized to receive injections of either Zyplast or mADG every 3 months, and clinical results were assessed with digital photographs by determining various physical parameters of lip appearance. By 1 year, mADG-treated patients were more likely than Zyplast-treated patients to show an increased upper lip vermilion height and visible surface, an increased nasolabial angle, and anterior projection and visible vermilion of the lower lip.

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