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What Is The technology Behind
silhouette Soft?

What Is The technology Behind
silhouette Soft?

Poly L-lactic Acid

Silhouette Soft suture is made of Poly-L-Lactic Acid while its cones are made of Lactide/Glycolide (82% Lactide -18% Glycolide). These components are totally bio-absorbable, biocompatible and biodegradable.

On each suture, there are two series of cones. Each series has the same number of cones, which face in opposite directions towards the extremity of each suture, hence the term « bidirectional ». The cones are separated by tied knots, placed at 0.5 cm (SMS 22 or 8 cones) or 0.8 cm (for SMS 23 (12 cones), and SMS 25 (16 cones)) intervals from each other, free floating between the knots.

Poly L-lactic acid (PLLA), the main component of Silhouette Soft is a well-known polymer that has been used for many years in a number of biomedical and pharmaceutical applications. It has a long history of use as bio-absorbable suture, a drug delivery system and in surgery – in particular in orthopaedic fixation devices such as pins, rods and screws. It is also a key material in the development of tissue engineering. These applications have been approved for human use by the US FDA. PLLA is generally classified as a safe material.

Poly L-lactic acid belongs to the group of aliphatic polyesters that share specific characteristics. Polylactic acid is biocompatible and bioresorbable; its breakdown process has been extensively studied: it acts by hydrolysing ester bonds, while its degradable components are resorbed through the metabolic pathways with the production of lactic acid, which is a naturally occurring substance in the body.

The physicochemical characteristics and properties of PLLA have been reviewed by several authors. PLLA is generally well-tolerated and, given its synthetic nature, no allergy testing is necessary before subject treatment; moreover its excellent safety record after correct implantation has been well-documented through extensive clinical experience and those clinical studies performed, involved thousands of subjects.

Once the suture is applied subcutaneously, through the process of re-absorption, the components of Silhouette Soft act by stimulating the fibroblasts and the collagen production. This action which continues over time helps to increase the volume and restores shapeliness to the face gradually and naturally.

Compared to other materials frequently used in the production of sutures, Poly L-lactic acid has a slower breakdown rate, consequently, its benefits are longer lasting.

Cone Technology

The uniqueness of the Silhouette Soft suture stands in the cone technology. It is the only resorbable suture with bidirectional resorbable cones.

The uniqueness of the Silhouette Soft suture stands in the cone technology. It is the only resorbable suture with bidirectional resorbable cones.

The cone has a 360º surface to retighten and immediately provide excellent anchorage points in the subcutaneous tissue. Collagen induction around the cones creates a solid support of the soft tissue, thus preventing risks of migration or extrusion. The entire surface of the cones is smooth, so that patients do not experience any “prickling” sensation. The cones provide a firm anchorage for the suture. While the cones are slowly break down, capsules form around them. These capsules, which are not present with barbed sutures, provide improved fixation points for superficial adipose tissue.

Collagen production around the cone*.

A micrograph (X40) of a histologic section showing a cross section (half cut) of a cone and ingrowing new fibrotic tissue.

Micrograph of the suture and cone*.

Image of the suture (X 40) with a knot in the center and one of the preserved polyglycolic cones surrounded by a fine collagen capsule.

Biopsy of a patient after 6 months of suture placement**.

A. Collagen production around and in the cone

Biopsy of a patient after 6 months of suture placement**.

B. Collagen production around the knots

*Facial Rejuvenation and Improvement of Malar projection Using Sutures with Absorbable Cones: Surgical technique and Case Series – Javier de Benito – Roberto Pizzamiglio – Dimitris Theodorou – Leyla Arvas – Aesth. Plast. Surg. DOI 10.1007/s00266 – 010-9570-2.

**Suture Suspension Technique for Midface and Neck Rejuvenation – Gloria Mabel Gamboa, MD, FACS and Luis O. Vasconez, MD, FACS – Souteastern Society of Plastic and Reconstructive Surgeons.

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