GOLD THREAD ZLOTE NICI

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GOLD THREADZLOTE NICI

• Skin tenser
• Body filler implant

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TOPICS FOR DEVELOPMENT

• Historical background
• Mechanism of action
• Indications
• Preoperative phase
• Technique

• Postoperative phase
• Complications
• Advantages
• Conclusions

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HISTORICAL BACKGROUND

• Ancient Egypt threads of pure gold
• 1960s Caux , subdermal gold threads in facial
  surface
• 1970s J.Conley and D.Baker, implantation of the
  thread under (and adapting to) the wrinkle
• 1992 D.Orenes (gold catgut), vertical and
  horizontal implantation
• 1992 application kit (Lorca Marin, S.A.),
  combining gold thread with simple catgut

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MECHANISM OF ACTION

• GOLD THREAD
• Produces a granulomatous reaction
  characterized by the appearance of abundant
  elastic fibres around the implant, together with
  neovascularization of the implant zone. This
  affords skin youthening in the implant zone.
• POLYGLYCOLIC ACID
• Produces minimum acute tissue inflammation,
  followed by gradual encapsulation by the
  connective tissue. Posteriorly, gradual tension
  strength is lost, with hydrolysis-mediated
  absorption that is completed within 60-90 days
  after implantation.

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MECHANISM OF ACTION
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INDICATIONS

• Incipient aging
• Elimination of flabbiness
• Filling of grooves and wrinkles

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• The correction of facial wrinkles is one of the
  main challenges in esthetic surgery and exerts a
  negative psychological and emotional effect upon
  patients.
• The existing surgical methods are traumatic and
  imply the need for anesthesia and postoperative
  period.
• Our aim is therefore to increase efficacy in
  combating and preventing involutional changes
  through skin firming with special surgical
  threads.

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SKINGOLD Gold Thread

• SKINGOLD is a filler implant developed by LORCA
  MARÍN for the prevention of face and neck ptosis,
  and flabbiness of the inner arm and thigh skin
  surfaces.
• SKINGOLD can also be used to correct neck and
  face wrinkles.
• SKINGOLD is applied by means of a simple
  ambulatory surgery technique.
• SKINGOLD has no adverse effects.

• SKINGOLD affords evident results within one
  month.
• SKINGOLD maintains the visible effects for more
  than 5 years.
• SKINGOLD is CE certified.
• SKINGOLD is a registered trademark of LORCA
  MARÍN.

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PREOPERATIVE PHASE

• Case history
• Treatment analgesic - antiinflammatory,
  antibiotic
• Informed consent
• Preoperative photographs

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TECHNIQUE

• Marking

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• Marking

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TECHNIQUE

• Preparation of the surgical field, with strict
  asepsis.
• Anesthesia
• either topical (EMLA type cream)
• or local subdermal infiltration at entry and exit
  points
• 10-15 ml lidocaine 2
• 0,1 ml adrenalin 1
• 25G 5/8 or 30G ½ needle
• Subdermal implantation of the gold thread
  (accordion effect)
• Compression
• Immobilization? (micropore dressing)

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POSTOPERATIVE PHASE

• Local application of ice
• Antibiotics (oral and topical)
• Immobilization (avoid facial gestures,
  micropore)
• Control after one week

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COMPLICATIONS

• Hematomas ecchymosis
• Infection
• Cords (superficial, granuloma)
• Extrusion
• Asymmetries - Dimples

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ADVANTAGES

• Rapid return to social and labor activity
• Important youthening
• WITHOUT scars
• NO pain

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TESTS CARRIED OUT

• Experimental clinical group A. V. Vishnevski
  Surgical Institute( Moscow).
• These investigators conduced comparative and
  experimental studies with implants of gold thread
  PGA and Trofilene ( PVDF ) in 300 patients.
• Study of the mechanism of action of gold thread
  (morphological changes).

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TESTS CARRIED OUT

• Clinical observations correction of involutional
  changes in face and neck.
• Immediate and long-term effects.
• Assessment of blood flow in the tissues
  surrounding the implant (SRSV).
• Evaluation of surrounding tissues.
• Tissue microcirculation.

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CONCLUSIONS

• 1.- Before treating the patient with this
  technique, evaluation is required of tissue
  condition objectively establishing the
  involutional grade and defining the choice of
  technique for firming, in order to be able to
  predict the outcome.
• 2.- The morphological changes around the implant
  are characterized by functional activity of the
  fibroblasts, collagen production and increased
  capillaries.

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• 3.- The procedure increases the microcirculation
  indexes between 44-53, thus favoring nutrition
  in the area.
• 4.- firming can be applied as prophylaxis (grade
  I cases) and as corrective measure (grades II,
  III and IV).

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• 5.- In grade I and II cases, the technique is
  effective as an independent method (75 good
  results).
• 6.- In firming of the infraorbital zone, implants
  should also be placed in the malar region and
  temples with implants in the rest of the face
  on a unified basis.
• 7.- In grade III cases it is advisable to implant
  supplementary threads in the oval facial zone.

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• 8.- In grade IV cases it is advisable to combine
  the procedure with surgical corrective measures
  (liposuction and ritidectomy / face lift).
• 9.- No leakage is observed after implantation of
  over 0,5 cm in young patients.
• 10.- In patients over 56 years of age, leakage of
  tumor-like appearance is observed, with local
  inflammation.

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GOLD THREAD KIT / SKINGOLD

• Ready to use (gold PGA), 25 cm length, boxes
  with 12 U
• Triangular straight, atraumatic needle (60 mm
  length)
• Gold thread (24 kt 99,99 purity) 0,1 mm diameter
• Colorless polyglycolic acid thread (caliber 3/0
  USP)
• Sterile (EO)
• Histocompatible.

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PHOTOGRAPHS OF CASES
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