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PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
HA FILLER Reborn Academy Atlas Book
20191st Version
REBORN ASTHETICO-PLASTIC CLINIC
PRESIDENT MD. BYUNGSUN KIM 원장 김병선
www.reborncorea.com
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER History
History of Aesthetic Filler
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER History
History of Aesthetic Filler
FAT : Started by Dr. Brung 1911
Using Cannula and Suction by Dr. Illouz 1978
Using Microlipoinjection by Dr. Pierre Fournier 1986
Using Tumescent by Dr. Jeffery Klein 1987
PARAFFIN : Started by Dr. Gersuny 1899
Faced Out : Granuloma and Migration
Liquid Silicone : Started by Someome 1940’s
USA FDA Proclaimed Negative Drug List at 1991
USA FDA Allowed Opthalmologic Usage 1994,1997
SilSkin => Off-Label Use
*Cohesive Silicone Gel :
USA FDA Breast Augmentation Material since 2006
“Gummy Bear”
COLLGEN:
• BOVINE COLLAGEN : COW Collagen
Strated by Zyderm (INAMED Corp.) 1981
Koken Atelocollagen 1986
Artecoll 1992
• POCINE COLLAGEN : PIG Collagen
Started by Fibrel 1985
Permacol Surgical Implant 2001
Evolence 2004 (Approved at 2008 in FDA)
• HUMAN COLLAGEN : HUMAN Collagen
Stared by Alloderm 1992
Cosmoderm 2003
PMMA: Poly-methyl-meth-acrylate
Started by Dr. Lemperle as Artecoll 1992 (Acryl 1: Bovine Collagen 3)
Artefill 2006
PAAG: Poly-Acryl-Amide Gel
Started by Interfall 1980s
Aquamid 2001
PLLA : Poly-L-Lactic Acid
Started by Sculptra 1999
CaHA
Started by Radiesse 2001
OTHERS
Bio-Alcamid: Polyalkyimid,
Isolagen: Fibroblast Culturing Solution,
Gore-Tex: ePTFE
Hyaluronic Acid . HA Filler
Started by Hylans 1980s(Hylan B Gel : Hyalform 1996)
Restylene 2003 FDA (NASHA : Patent 1995)
Hyalform 2004
Winners of Aesthetic Filler
HA Filler
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
(C14H21NO11)n D-Glucuronic Acid N-Acetyl Glucosamine
Na
HUMAN BODY
COMPONENT
Natural Substance in Human Body
Human Cell Membrane, Cartilage, Eye, Skin
CHARACTERS
Molecular Weight: 401Da(3~4M Da in Human Body)
Melting Point : 107.8oC
Non-Immunogenicity. Non-carcinogenic.
Non-teratogenic . Non-migratory
High Viscoelasticity
Biocompatible Biosynthesis : Streptococcus Equi
Biodegradability(within Several days)
Polymer : Repeatable Disaccharide Structure
Possible Molecular Modifying Sites
Synthesis : Hyaluronan Synthase
Water Retention Capacity
Non-Cross Linked 300Times than MW
Cross-Linked 1000Times than MW
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
Biodegradability(within Several days)
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
Biodegradability(within Several days)
BDDE . DVS
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
Biodegradability(within Several days)
Valuation Standards of HA Filler
Commercial
Standards
Experienced Doctor’s Opinion
Safety. Price. Longevity
Promotion and Marketing Power
Brand Value
Technical Standards
Size of Gel Particle
Uniformity and Distribution of Gel Particle
G’(Viscoelasticity )
Crosslink Rate
Crosslink/Pendant Ratio
Concentration of HA
Gel/Fluid Ratio
Hydration Rate
Dissolving Method
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
Biodegradability(within Several days)
Crosslink
Site Radial –COOH and Radial -OH
Crosslink
Material
BDDE : 1,4 Butanediol Diglycidyl Ether
LD50 :1,134mg/kg
DVS : Divinyl Sulfone
LD50 :32mg/kg
Crosslink
Purpose
Water Insoluble : Increase ViscoElasticity
Hyaluronidase Insensitive : Increase
Longevity
Crosslink
Tip
Crosslink Rate : More and Less 1%
Crosslink-to-Pendant Ratio : 50%~80%
Visco-Elasticity
Index
G’ : Elastic Modulus
G” : Viscous Modulus
G’
Elastic Modulus
G’=Stress/Strain “Gel Hardness”
Resistance against External Physical Stress
Increase Life Span
Normal HA Filler G’: 100~1000Pa, Dermis G’:
3,000,000Pa
Monophasic << Biphasic
Shear Rate Injection: Low Viscosity at High Shear Rate
=> Intradermal: High Viscosity at Low Shear Rate
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Characteristics
Characteristics of Hyaluronic Acid as Cosmetic Use
Biodegradability(within Several days)
Degradation
Hyaluronidase
Vertebrate Type Endo-b-Acetyl-Hexosaminiudase
Hyaluronate-Lyase
Hyalurono- Glucuronidase
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Techniques
Techniques
Biodegradability(within Several days)
Classic Layer to Injection Modern Layer to Injection
Dermal Cutting Technique Linear Threading Technique
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Pushing Head Technique Linear Threading Technique
Cross Hatching Technique Fan Technique
Cross Technique
Fern Pattern Technique
Techniques
Techniques
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Cross Technique
Fern Pattern Technique
Techniques
Techniques
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Techniques
Techniques
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER Filling
Forehead Anatomy
Biodegradability(within Several days)
Nerve Artery
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
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A. FILLER
Forehead Dermal Filler
Biodegradability(within Several days)
Forehead Augmentation
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Forehead Dermal Filler
Biodegradability(within Several days)
Temple Hollow Augmentation Worry Line Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
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A. FILLER
Mid Face Anatomy
Biodegradability(within Several days)
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid Face Anatomy
Biodegradability(within Several days)
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid Face Anatomy
Biodegradability(within Several days)
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid Face Anatomy
Biodegradability(within Several days)
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
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A. FILLER Midface
Mid Face Anatomy
Biodegradability(within Several days)
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Mid-face Dermal Filler
Lower Eye-line Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Mid-face Dermal Filler
Tear Trough Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid-face Dermal Filler
Nose Bridge Augmentation
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid-face Dermal Filler
Nasal Columella Augmentation
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid-face Dermal Filler
Cheek Augmentation
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Mid-face Dermal Filler
Naso-labial Folder
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Low-face Anatomy
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Low-face Dermal Filler
Lip Augmentation
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Smoking Line, Philtrum Ridge, Cupids Bow, Vermilion Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Low-face Dermal Filler
Chin Augmentation
Marionettes Line Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Breast Filler
Above Pectoris Major
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
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A. FILLER
Biodegradability(within Several days)
Buttock & Hand Filler
Above Periosteal Area and Fat Layer Intra Dermal Layer
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Vagina & Penis Filler
Connective Tissue Connective Tissue
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Biodegradability(within Several days)
Vaginal Filler
Connective Tissue Connective Tissue
Filling
Each 5ml LONG ACTING PLLA + HA FILLER
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
A. FILLER
Scar Filler
Subcision and Filler
Filling
PRESIDENT MD. BYUNGSUN KIM
원장 김병선
www.reborncorea.com
THANKS A LOT
리본의원 리본의원
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