INDICATIONS




Although basically idealized for the correction of facial rhytides, the indications for META<>CRILL® has been growing as medical specialists from areas other than Plastic Surgery and Dermatology have become familiar with the substance.

The common goal of all methods of cutaneous filling is the improvement of the nasolabial and glabellar folds. This indication has been extended to the frontal and periorbital rhytides, although these last indications do not give safe and predictable results as the ones produced with the initial indications. This is especially true of the periorbital rhytides, which are not a good indication for the technique.

The expansion of the atrophied facial subcutaneous compartment has shown very interesting results, mainly bringing benefits to patients in whom the fat involution process is more intense. We have been achieving excellent results in the facial rehabilitation of AIDS patients, in which the facial sequels promote a real discrimination of the patient, socially and professionally. The reconstruction of the facial subcutaneous space in this kind of patient is an excellent indication for the use of META<>CRILL®.

The volume increase over bony surfaces, like the malar bones and chin, is also possible, with the deposition of META<>CRILL® from the justa-periosteal area, in a deep plane, intramuscular and justa-periostal.

Large depressions, like Rhomberg's hemifacial atrophy and those secondary to infectious processes with destruction of soft tissues of the face can be aesthetically corrected by serial injections of META<>CRILL®, in repeated sessions.

The treatment of the perioral area has shown promising results. Volume increasing of the lip, with enhancement of the white roll, with the improvement of fine wrinkles, is easily obtained with tissue expansion with META<>CRILL®. Also, the labial clefts and the vermillion traumas can be satisfactorily corrected with small amounts of META<>CRILL®, with no need for elaborated and not always well-succeeded surgeries in this region. The expansion obtained by the implant in the superior lip considerably improves the aspect of the senile lip. The areas of depression in the inferior lip can also achieve benefits from the injection.

The so called "witch's chin" can be greatly improved by the META<>CRILL® implant in the linear depression area of the supra-hyoid area.
The treatment of nasal deformities, primary as well as for correction of previous rhinoplasty, is another promising field.

In this way, a nasal tip can be defined with a small amount of META<>CRILL®, in the place of a cartilage graft.

The tip rising, the giba camouflage, the correction of small lateral deviations shows perfectly possible and is nowadays the most gratifying procedure of this method.

Deformities secondary to incomplete fractures of the nasal bony skeleton, with the telescoping of the cartilaginous portion, can also be greatly benefited by the META<>CRILL® implant in these areas' junction.

The hidden columella and the anterior nasal spine can be corrected in the same fashion.

Lateral nasal deviations secondary to traumas, can be masked by the expansion of the depressed side.

The saddle-nose deformity, secondary to trauma or to surgery, can be corrected by the implant.

The META<>CRILL® easily corrects the small contour alterations of the dorsum after surgery.

The decrease of the fat layer of the auricular lobule seen in the elderly patient can be greatly softened in the remaining lobule.

Acne sequel can be softened by the META<>CRILL®, in an isolated way or after liberation of the scar retraction with a small incision.

Depressed scars, linear or not, due to traumas, can also be treated by the META<>CRILL® implant, performed traditionally or in an identical manner to the one formerly described, after the surgical liberation of the skin that is adhered to the deeper planes. The leveling of the scar in relation to the neighboring areas promotes a camouflage, leaving it less noticeable.

Vello-pharyngeal insufficiency can be attenuated by an increase in the volume of the soft palate and mainly the uvula, with the META<>CRILL® injection, decreasing the nasal escape and therefore improving speech.

META<>CRILL® also finds a huge field of utilization in the complements of rhytidoplasties. The expansion in the nasolabial and nasocheek folds, that are persistent after surgery, is easily achieved.

The alterations in the mandible line contour, or any localized depression, such as under the zygomatic arch, are all excellent indications for the use of META<>CRILL®.

The correction of the tragus, when it has been dislodged, generally by excessive traction of the facial flap, is possible by the injection of META<>CRILL® in that site.

The injection can be performed during surgery by a percutaneous route or under direct vision, placing META<>CRILL® immediately under the subcutaneous surface, which is exposed during the surgical act.

The injection of META<>CRILL® in cases of "cellulitis" in the inferior limbs and gluteus regions is being researched with promising results, but we still have not had enough time of observation, having achieved reasonable expansion in the areas of depression.

The treatment of dorsum hand in the elderly is achieved by implant of META<>CRILL® in the spaces between the extensor tendons in the dorsum, where the fat had atrophied.

The contour of tights, legs and ankles can be ameliorated with the implant.

The penile augmentation achieved by implant in the celulosa layer has showed promising results

The initial studies about the possibility of expansion of atrophied cardiac valves as result of infectious diseases has show good results.