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March 2004

Cosmetic Surgery TimesCosmetic Surgery Times ®

Where the Exchange onAesthetic Perspective Begins

I M P L A N T T E C H N O L O G Y U P D AT EI M P L A N T T E C H N O L O G Y U P D AT E

By Rebecca Bryant STAFF CORRESPONDENT

Hollywood, Fla. — Advanta facial implants arethe most advanced filling technology avail-able, and the missing link in completing afull-facial rejuvenation in a minimally inva-sive way, according to Jim Gilmore, M.D.,FACS, FICS.

“You can reshape the jaw, the midface, andthe neck, but there’s still a lot of aging aroundthe mouth,” said Dr. Gilmore. “The questionis: ‘What kind of material is available?’ In thepast, materials were temporary, irregular, orhard. We have a new generation of injecta-bles, like Restylane, recently FDA approved,but they are not permanent fillers. Collagenis very good, but it too, has to be replaced.”

A facial plastic and cosmetic surgeon with apractice in Dallas, Texas, Dr. Gilmore has per-formed more than 500 Advanta procedures inapproximately 150 anatomical sites. “I’ve beenvery pleased with the product,” he said. “Thisis the best in the ePTFE group, because of soft-ness. Patients want correction, but they wantto feel natural.” Advanta facial implants areconstructed from expanded polytetrafluo-roethylene (ePTFE) by Atrium Medical Corp.The technology has been successfully used inarterial grafts and in the reconstruction ofarteries for more than 30 years. What makesAdvanta different from earlier ePTFE prod-ucts is its architecture: a highly porous cen-ter surrounded by a smooth outer envelopeof medium porosity.

Dr. Gilmore considers the implant perma-nent because its architecture facilitates bioin-tegration. Over time, blood vessels and col-lagen grow in and through the porous mate-rial in a more natural healing response. Fur-thermore, this material parallels that of thehuman body.

He described Advanta as a soft materialavailable in cylindrical, round, or oval forms.He uses the alloplastic for rejuvenation of thenaso-labial, mandibulolabial, lips, glabellar,and other facial areas. “The greatest advan-tage is the lips and the corners of the mouth,”he said.

Dr. Gilmore implants the filler under localor sedation anesthesia. To augment or fill alip, he makes a tiny incision in the corner ofthe mouth and glides the material throughsubcutaneous tunnels, closing with suturesor tissue glue.

The surgeon has devised a procedure, coinedthe “ml-croisade” (ml for mandibulolabial;croisade, the French word for cross) to fillproblematic drool lines. “You fill in the ‘drool’line and at right angles to it,” he said.

Material tolerated wellBased on follow-up patient surveys, Dr. Gilmorereported an 86 percent satisfaction rate. “Thematerial is well-tolerated,” he said. “I’ve hadno nerve injuries, an asymmetry rate of under

one percent, and an infection rate of underone percent.” Unlike other fillers and aug-menters, if there is a complication or if apatient is dissatisfied, Advanta can be easilyremoved.

The surgeon recommended against dou-ble implantation in the same implant site.“You can’t predict how it’ll align,” he said.“There may be certain disease sites that arecontraindications to implantation,” reportsDr. Gilmore.

Dr. Gilmore believes surgeons should useevery modality possible to prevent infections.“After saturating implants with antibiotics,”he said, “I irrigate and carefully close, usingvery sterile techniques. I put patients onantibiotics before and during implantation,and prescribe a course afterwards. They arealso on an antiviral for two days before theprocedure and for a week afterward.”

When asked if the intense antibacterialstrategy would build patients’ resistance toantibiotics, he responded that the preventa-tive treatment was of short duration, and forthat reason, should not have negative conse-quences to the patient’s future response toantibiotics.

“Advanta is a significant advancement innatural-feeling fillers that appears to have lowmorbidity and high patient satisfaction wherepermanency is the issue. This technologyaffords the opportunity for definitive cor-rection without the need for repeated treat-ments,” Dr. Gilmore said.CST

Dr. Gilmore reported that he has no financial interest in Atrium Medical Corporation or its products.

For more information on this article andAdvanta facial implants visit:

www.jimgilmore.com and www.atriummed.com

Facial implants seen as vital cog in full rejuvenation

©Reprinted from COSMETIC SURGERY TIMES, March 2004 AN ADVANSTAR ★ PUBLICATION Printed in U.S.A.

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