Dermal extracellular matrix response to facetem implant: a randomised controlled experimental study

Background. A leading concept in modern regenerative medicine is the perspective of using own body resources to remodel organs and tissues via the formation of “living scaffold”. A pivotal role in the formation of dermal scaffold is played by fibroblasts that produce extracellular matrix (ECM).

Aim. A study of the fibroblast activation mechanism mediating synthesis of the dermal ECM fibrillar component under the Facetem filler administration.

Methods. The experimental trial was conducted in Wistar male rats (72 animals). Animals had 0.05 mL Facetem (Korea) injections subdermally. The filler is a calcium-containing product featuring gradual degradation delivered through structural microspheric properties of the Lattice-pore technology. Biological material was sampled at weeks 1 and 2 of months 1, 2, 3 and 5. Tissues were paraffin-embedded in standard histological assays and stained with Mallory’s trichrome, Picrosirius red in polarisation microscopy and immunohistochemistry with collagen types I, III and elastin antibodies (Abcam).

Results. Collagen distribution in dermis and the filling zone suggests that collagen production occurs by week 2 of the Facetem filler placement followed by an increase in synthesised matrix volume to 4.39 ± 0.7 for collagen type I and 3.9 ± 0.2 for collagen type III (p < 0.05). The synthetic activity of fi broblasts reduces by month 3, albeit with collagen production remaining above control even by the end of month 5. Elastin synthesis also initiates by week 2 of the filler injection in dermis and grows by month 3.

Conclusion. The presence of Facetem filler triggers a foreign body inflammatory response in dermis. This multifactorial process initiates with protein adsorption proceeding to dermal cell recruitment and modulation of fibroblasts and macrophages. Activation of these cell types induces neocollagenesis entailing the extracellular matrix synthesis and expansion in dermis.