A human placental tissue allograft could be the next hyaluronic acid filler alternative for aesthetic patients, according to Miami, Fla., based plastic surgeon Rian A. Maercks, M.D.
Dr. Maercks is testing AmnioFill (MiMedx), a product commercially available for homologous use as a placental connective tissue matrix to replace or supplement tissue in acute and chronic wound care, according to the company’s website.
The plastic surgeon has used the tissue allograft as an investigational filler to treat the faces of eight patients and is in the process of monitoring them for outcomes.
There are several draws to having such an alternative to hyaluronic acid (HA) dermal fillers, Dr. Maercks says.
“One, it’s natural, native human tissue. Number two, it’s filled with growth factors, that are important to fetus development and support, which, at least theoretically, should activate some vascular cells and, potentially, stem cells locally when it’s used, causing an in-growth of healthy tissues. That’s the real exciting thing,” Dr. Maercks says.
Another advantage of the non-HA filler: Its proteins are hydrophobic.
“One of the difficulties with hyaluronic acid-based fillers, which are really the best on the market, is that they are very hydrophilic, which gives them the power to maintain volume but also makes them swell a lot and causes that recovery period of swelling,” Dr. Maercks says. “With hydrophobic compounds, there is a much reduced, and sometimes even absent, swelling part of the recovery, which is really important for high-demand patients who want to come in and get something done without recovery.”
AmnioFill Research Insights
Dr. Maercks is conducting follow-ups with his AmnioFill patients to gauge tissue response and lasting power compared to treatment with HA-based fillers. He was at about six months of follow-up in late January 2018.
So far, he tells The Aesthetic Channel that use of AmnioFill in the periorbital, perioral, nasal and cheek areas of the face offers a diminished recovery compared to HA fillers.
“With the technique I use, I don’t get bruising, but the swelling is [also] diminished,” he says.
AmnioFill comes in a powdered form and needs to be reconstituted, according to Dr. Maercks.
“In general, the amount of product that I reconstitute to about 3 ccs, I estimate has about 1 to 1.5 ccs of effect compared to hyaluronic acid. That means that a 3 cc use is going to give you the effect of about 1.5 ccs of hyaluronic acid,” he says. “Right now, the cost-to-volume ratio is not good compared to hyaluronic acid fillers. But the potential benefit of skin changes and tissue stimulation may outweigh that. It’s something that we’re looking into. A lot of patients prefer to spend extra money just to have less recovery and potentially have the positive effects.”
Dr. Maercks offers patients a commercially available human adipose tissue filler product, Allofill (Biologica Technologies).
“[The manufacturer takes] human adipose tissue, removes all the fat and then processes it similarly. It also has some growth factors but not quite the profile of the amniotic tissue,” he says. “I’ve had really good results with Allofill, as well.”
Allofill, according to the company’s website, can be used to fill soft-tissue defects as a noninvasive alternative to surgical fat grafting with one’s own tissue, eliminating the need for fat harvesting with liposuction.
But AmnioFill is a non-viable cellular tissue matrix allograft that contains multiple extracellular matrix proteins, growth factors, cytokines and other specialty proteins present in placental tissue, according to MiMedx. Its shelf life is five years, at ambient conditions. And AmnioFill is processed according to the American Association of Tissue Banks standards, and is regulated as a human cell, tissue or cellular or tissue-based product under Section 361 of the Public Health Service Act, according to Mimedx.com.
Patients are receptive to placental tissue filler products, according to Dr. Maercks, because they tend to like the idea of using natural human tissue. MiMedx’s AmnioFill should be on the market as an aesthetic dermal filler within two years — once there are strong guidelines for aesthetic use, according to Dr. Maercks.
As for dangers or warnings, Dr. Maercks says there are certain risks associated with any procedure.
“There are all kinds of theoretical risks that I’ve never encountered, including thrombosis, tissue loss, even blindness has been reported. As far as specifically with this product, the risks that go along with allograft tissue apply to it. But allograft processing is very highly regulated and is very safe,” he says.