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DONALD J. CAPUANO, M.D.
Plastic Surgeon

FASCIAN FOR WRINKLES

Fascian Injections Fascia is the medical name for the sheets of thick, white connective tissue that are located throughout the human body. These layers of fascia wrap around many of the muscles and internal structures, packaging them and giving them support. Surgeons commonly sew layers of fascia together because they are strong and hold sutures well. Fascia is living tissue and is largely composed of the protein collagen. You may have heard of collagen injections before. Collagen is found in many tissues besides fascia, such as skin, cartilage, and tendons. Fascia is obtained from a human cadaver donor and then processed and preserved. Specifically, fascia is obtained from the muscle in the buttocks and ankle. Each donor is carefully screened for diseases that might commonly be transmitted. The material is screened according to the guidelines of the American Association of Tissue Banks. The preservation typically involves freeze-drying, so that the material can be stored for long periods of time before being used as a graft. (Grafting involves removing a piece of tissue from one individual or area of the body and inserting it into a different individual or area of the body). Since fascia is a naturally thick material, it often takes the body many months to digest. In addition, a layer of scar tissue may appear and function in a fashion that is similar to the original fascia. The resultant material often remains in the area indefinitely and studies have shown that in many instances fascia grafts are effective many years, even decades, later. Fascian is a special preparation of human fascia. To make Fascian, preserved fascia grafts are procured in the traditional manner and then processed under sterile conditions to different particle sizes. The material is then supplied to doctors in a form which can be easily stored, and then rehydrated and injected when it is needed. The use of preserved fascia as a graft material has been in use since the 1920'S. Fascian, which is an injectable form of preserved fascia, has only recently become available to physicians. Dr. Capuano will decide if Fascian is an appropriate material for injection in each instance. Unlike collagen, test insertion in a remote area of the body, to pre-evaluate the reaction to the material, is usually unnecessary with fascia grafts. Routinely, the local reaction to the site of injection is mild and pain-free, however, many factors may influence the extent of bruising and swelling. These include the amount of material injected, the depth at which it is injected, the area of needle dissection performed by the doctor to create a pocket for implantation, the particle size selected, etc. Fascian may feel thick or lumpy in the area, especially for the first few weeks after injection, but typically the graft site will soften. Some re-absorption of the material is to be expected. This will depend on many factors, including the size of areas being treated and the amount of material placed in the area. Infection is possible with any injection or implant, although it is very uncommon. Often, the contaminant is a bacteria from the patient's own skin surface. Injection into an area that is already infected or inflamed is not advised. A local infection may result in tissue damage and scarring. Scar tissue may develop at the injection site and to some extent this may be an acceptable part of the correction of the defect. An adverse reaction of any other kind to this graft material, e.g.. a local or systemic allergic response, would be rare, but the possibility must be considered. To date, no true allergic reactions have been reported and likewise, infection resulting from the implant material itself has not been described. Since the injection site is a small area, a significant numb area would be rare. Nerves are very slow to heal and it may be many months before sensation fully returns. Some areas of numbness may be permanent. The procedure: The doctor will mark the area to be treated. The area will then be cleansed and sterilized. Next, the area will be anesthetized. An anesthetic will be combined with the fascia in rehydration. It will take from 5-15 minutes to completely rehydrate the fascia. After injection, pressure will be applied to the area to minimize bruising. Cold compresses may be continued for 1-2 hours after injection. Fascian typically spreads evenly and smoothly through the tissue. The exact cosmetic configuration cannot always be achieved. Sometimes touch-up procedures are required. The practice of medicine and surgery is not an exact science and although good results are expected with the use of FASCIAN, there cannot be guarantees, warranty, or assurances expressed or implied, as to the results that may be obtained. For a link to the FASCIAN home page click here. All information written and pictorial on this page and all links at CapuanoUSA.com Copyright and Copy 1982 through present Donald J Capuano MD

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