The authors present their experience with the use of Zyplast (glutaraldehyde crosslinked collagen) for the treatment of skin creases in the aging face, lip augmentation, scars, and facial atrophy. One hundred female patients were studied over a nine-month period. The results were found to be superior in some aspects compared with Zyderm II collagen, but there is loss of correction after six months and repeated "top-up" injections are needed every four to six months to maintain a satisfactory cosmetic correction. Zyplast collagen has not reduced the number of patient visits nor the cost of treatment.

Morbidity of the conchal cartilage donor site is evaluated in this article. Forty-two patients (from 1984-1994) with 44 donor sites were reviewed retrospectively. In 27 cases an anterior approach was used and in 17 cases a posterior approach was used. Four complications were observed: two cases of delayed healing in the post auricular approach, one case of flattening of the ear after an anterior approach, and one case with an anterior hypertrophic scar was seen. Only one case needed further surgical intervention. The anterior approach is technically easy, safe, and quick to perform but should be avoided in patients with a history or genetic predisposition to keloid or hypertrophic scars.

This is a preliminary report of the use of a device to apply small pulses of radio-frequency energy to surgical wounds in order to improve wound healing. The device was applied to one eye in 21 patients who underwent bilateral blepharoplasty. There were no device-related complications. In 11 patients, edema and ecchymosis were noticeably less on the treated side within 24 hours of surgery. In 6 patients, ecchymosis and swelling were so slight that no difference between treated and untreated sides was visible. Two patients were noticeably worse on the treated side. Further studies will be conducted.

Results are presented of dermis grafts used in conjunction with surgery for aging changes in the face. During a two-year period grafts were used to correct crease lines in the glabella and nasolabial creases, as well as angles of the mouth and vermilion. Volume of the grafts was well maintained and very few complications occurred. This technique offers better long-term results than can be obtained by collagen or fat injections. The results and techniques are presented in detail.

The main indications for Zyderm Collagen Implant in the face are for the correction of acne scars and facial wrinkles, such as the lines of the forehead, crow's feet, naso-labial crease lines, and creases of the lips. Few complications have been found, but it is vitally important that patients are carefully assessed and well informed before treatment is commenced.