Prof Ayse AKMAN KARAKAS
Dermatologue
Collaborateurs: Dr. Şebnem Demir, Dr. Özge Güzelad, Prof. Dr. Fatoş Belgin Yıldırım, Prof . Dr. Murathan Küçük, Prof. Dr. Nuray Acar Aydemir, Prof. Dr. Sadıka Halide Akbaş, Prof . Dr. İnanç Elif Gürer, Prof. Dr. Ayşe Akman
IN-VIVO AND IN-VITRO BIO-FILLER DISSOLVING BY PROTEASE, PHYSIOLOGICAL SALINE, ALTEPLASE, COLLAGENASE AND HYALURINIDASE
Objectives: Learning the effectiveness of the saline, hyaluronidase, protease, alteplase and collagenase in dissolving of bio-filler in-vitro and in-vivo.
Introduction: Bio-fillers are popular aesthetic applications and are better tolerated than high-density hyaluronic acid fillers. However, there is not enough data about management when complications develop. In this study, we aimed to evaluate the effectiveness of dissolvent substances such as hyaluronidase, protease, alteplase, saline and collagenase .
Materials / method: 6 male New Zealand rabbits weighing 3-4 kg were used and the approval of the Akdeniz University Ethics Committee was obtained (protocol no: 12122024.04.004). Rabbits were treated under ketamine and xylazine anesthesia; the ear scalp was shaved and the posterior auricular artery was identified. Biofiller was applied by 0.2 ml and the other substances were applied by 1 ml intraarterial injection. Rabbits were observed and photographed on days 0, 1, 2, 4 and 7.
For in vitro studies, 250 μι biofiller and solvents. The Mixtures were cantified eith image analysis software.
Results: After intraarterial injection of bio-filler, the ears gradually turned dark blue. At the end of the 7th day, the ears were pinker in the filler+protease and filler+physiological groups of filler, while partial pinkness was seen in the filler+collagenase group. In the filler+alteplase group, echimose was observed in the first days and pinkness on the 7th day. In the filler+hyaluronidase group, the ears remained blue-black.
According to our in vitro results, the highest average particle count was seen in the bio-filler+protease group. The second,, third highest were saline, collagenase ggroups.
Conclusion: In our study, the most effective dissolving substances in bio-filler applications were determined as protease, physiological saline and alteplase; collagenase was found to be less effective.
The data obtained suggest that the use of protease in arterial pressure and vascular complications requiring sudden and rapid intervention during bio-filler filling applications, diluation with physiological saline or the use of products containing protease and collagenase, alteplase can eliminate an advanced complication.
