A double-blind, clinical evaluation of facial augmentation treatments: a comparison of PRI 1, PRI 2, Zyplast and Perlane.

BACKGROUND: Facial wrinkles are caused by weakening of the sub-dermal collagen support layer. Dermal fillers can be used to treat wrinkles, and this double-blind, randomised, single-centre study compared four fillers: PRI 1, PRI 2 (both porcine collagen), Zyplast (purified bovine collagen) and Perlane (cross-linked hyaluronic acid gel). METHODS: 79 females (aged 25-55 years) with wrinkles in the upper lip line border were randomised to PRI 1 (19 patients), PRI 2 (19 patients), Perlane (23 patients), Zyplast (18 patients). Patients were assessed at 1 week and 1, 3, 6, 9 and 12 months using 2D images and by mathematically derived facial volume changes using 3D stereophotogrammetry. RESULTS: All treatments produced larger, less wrinkled, more prominent lips. PRI 1, PRI 2 and Zyplast showed similar lip volume gains, with Perlane showing the greatest upper lip volume increase. All treatments were comparable for rates of decrease in upper lip volume post-treatment, however, Perlane maintained higher lip volume gains at each time point. Investigators indicated PRI 1 was significantly easier to deliver than Zyplast. Patient satisfaction scores were similar, though there was a trend towards greater dissatisfaction for PRI 1 and PRI 2 at month 9 (p=0.052). Treatment was well-tolerated, with 'cold sore' being the most common adverse event. CONCLUSIONS: Results showed that PRI 1 and PRI 2 were comparable to Perlane and Zyplast as dermal fillers. Further rigorous studies are required to establish the performance of dermal fillers and patient acceptability. We propose the utilisation of stereophotogrammetry for assessment of volume changes.

Three-dimensional imaging in orthognathic surgery: the clinical application of a new method.

Many 3-dimensional (3D) techniques have been utilized to register and analyze the face in 3 dimensions, but each system has its own merits and disadvantages. C3D is a relatively new 3D imaging system that was developed to capture the 3D geometry of the face. Landmark identification on 3D facial models is facilitated by a software-based facial analysis tool developed by the authors. The reproducibility of landmark identification was high for 20 of the chosen points (standard deviations of repeated placements of landmarks around their centroids were 0.5 mm or less). The method is useful in studying facial soft tissue changes following orthognathic surgery and other types of facial surgery, as well as assessing facial soft tissue growth and development of the craniofacial complex.

Three-dimensional facial characteristics of Caucasian infants without cleft and correlation with body measurements.

OBJECTIVE: The aim of this study was to characterize the soft tissue facial features of infants without cleft and to report on the correlation between these with weight, length, and head circumference. DESIGN: This was a prospective study using a noninvasive three-dimensional (3D) stereophotogrammetry (C3D) system to capture the images of the participants. Landmarks were identified on the 3D facial images. Means and SDs were derived for facial distances and angles. A facial asymmetry score was calculated for each image. Two sample Student's t tests, Pearson's correlation coefficients and analysis of covariance were used to ascertain any gender differences and determine whether these could be explained by weight differences. PARTICIPANTS: Eighty-three infants, 41 boys and 42 girls, were captured at rest with their lips apart, at approximately 3 months of age. RESULTS: Significant sex differences, of 1 to 2 mm, were found in several facial dimensions, such as face height and nose width. The larger facial measurements correlated significantly with body measurements. Analysis of variance confirmed these differences could be explained by differences in weight. There were no sex differences in the nose/mouth width ratios or in any of the angles measured, suggesting that there may be little sex difference in shape. A slight degree of asymmetry in the faces of infants without cleft was detected. CONCLUSIONS: Comparisons between noncleft controls and infants with cleft should take cognizance of normal age and sex variations in height and weight that occur among infants.