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Source: KOSMETIK international journal, No. 4/2013, pp. 72-73 ______________________________________________________________________________ Ellanse is a dermal implant based on the medical suture material polycaprolactone, used in the field of plastic surgery for more than 40 years. The process of biodegradation of polycaprolactone occurs spontaneously in the presence of water, first to monomers, and then to carbon dioxide and water, and the rate depends on the degree of polymerization of the hydrocarbon chain. There are four types of Ellanse fillers with different durations of the corrective effect - from 10 months to 4 years. Stage 1. Inspection and makeup removal We carry out examination, palpation, history taking and consultation of the patient, and sign an informed consent protocol. We perform makeup removal with products based on your skin type. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/1%2819%29.png" style="height:432px; width:650px" /> Stage 2. Marking injection zones To determine the insertion points in the cheek-zygomatic region, we make markings in a standing or sitting position. We mark two lines: the first - from the corner of the mouth to the outer edge of the eyebrow, the second - from the corner of the nose to the tragus. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/2%2815%29.png" style="height:432px; width:650px" /> The point where these lines intersect is the first point for insertion of the cannula (McGregor&#39;s point). From it we carry out reinforcement with a “fan” or “sun”, capturing the tear trough. If we form 2-3 insertion points, then we place the “fans” overlapping. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/3%2812%29.png" style="height:432px; width:650px" /> Stage 3. Anesthesia Apply anesthetic cream under the occlusive dressing. After 30–40 minutes, remove and treat the injection area with a disinfectant solution of chlorhexidine bigluconate 0.05%. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/4%2812%29.png" style="height:432px; width:650px" /> Step 5: Preparing the syringe We open the package with the drug, paste the sticker with the batch number into the patient’s card. We put a cannula on the syringe and be sure to check its patency. Stage 6. Injections We insert a short needle of a larger diameter than the cannula into the injection point to a depth of 2 mm. An entrance hole is formed, droplets of blood appear. We insert a cannula into the hole. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/5%289%29.png" style="height:432px; width:650px" /> Stage 7. Administration of the drug We move the cannula into the tissues at the level of the border of the dermis and hypodermis (when lifted, the cannula is contoured, but not translucent) using back-and-forth movements. Ellanse is administered subdermally, linearly retrograde, in a volume of approximately 0.01–0.02 ml for each cannula pass when forming a “fan”. We place the individual “ribs of the fan” quite close to each other. The drug is administered slowly, with even pressure on the piston. In terms of physical properties, the preparations do not differ from each other in either density or viscosity, are used using needles or cannulas of the same size and are selected with a focus on the specific duration of the cosmetic effect, taking into account the doctor’s recommendations and the client’s wishes. After treating each zone, knead the injected drug a little. Method of administration: flexible 27 G cannula 40–50 mm long or standard 27 G needle 13 mm long. Consumption of the drug for reinforcing facial skin: 1–2 ml (depending on the severity of soft tissue ptosis). <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/6%287%29.png" style="height:432px; width:650px" /> Stage 8. Final care Skin treatment and hemostasis during the procedure are carried out with cotton pads moistened with an antiseptic solution. Thus, the middle and lower third of the face is reinforced. After completing the injections, the skin is again treated with an antiseptic. In case of severe redness and high skin reactivity, cold can be applied for a short time. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/7%284%29.png" style="height:432px; width:650px" /> Then apply Traumeel S ointment to the injection area (the drug provides anti-inflammatory, decongestant and protective effects). During injections, the patient may experience a slight tingling, burning or swelling sensation at the injection site, which goes away on its own within 3-5 minutes. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/8%281%29.png" style="height:432px; width:650px" /> As a rule, when using a cannula, hemorrhages do not form. Swelling may be noted in the periorbital area and persist for 2–3 days. Skin care recommendations are described in detail in the informed consent protocol. Lifting of the cheek-zygomatic area, smoothing of the tear trough and nasolabial fold are observed immediately after the procedure. <img alt="" src="https://pro.bhub.com.ua/cosmetology/upload/images/9.png" style="height:432px; width:650px" /> But after 2–2.5 months an examination is necessary: by this time the effect of the Ellanse filler injection is completely formed. 10 weeks after the introduction of dermal filler, it is permissible to carry out physiotherapeutic procedures aimed at improving the condition of the skin and increasing muscle tone (microcurrent therapy, cosmechanics, etc.), mesotherapy and biorevitalization. 2 months after bioreinforcement with Ellanse fillers, the remaining fine superficial wrinkles can be corrected with hyaluronic acid fillers, which are injected superficially intradermally. Duration of the procedure: about 60 minutes. A second injection can be performed after 2-3 months - for correction or after the expiration of the drug (after 1.5-4 years, depending on the type of Ellanse filler used - S, M, L, E). Home care Home remedies with cytokines or green tea extract from the Natura Bisse line (Spain).

Vector lifting with Ellanse dermal filler