DERMATOLOGICALS

Dermal Fillers: From Wrinkle Filler to Facial Sculptor

CRM® - Covalent Reticulated Copolymer

The German company behind Matridur® and Matridex® have now launched a new range of non-animal hyaluronic acid based fillers under the brand name CRM®, which relates to their Covalent Reticulated Copolymer Matrix technology. This has now been available in the UK since March 2008.

CRM® technology uses a cross-linking agent called Butanedioldiglycidylether (BDDE), one of the least toxic of the cross-linking agents, which it is claimed increases the resistance of the gel to degradation. The manufacturers also note that CRM® Technology produces a gel of a greater purity which virtually eliminates immune reactions, making it safer for patients and it is retained longer in the tissue for a longer-lasting result.

The range consists of crm-DEX, used for treating deep wrinkles and folds such as glabellar (frown), nasolabial (nose-to-mouth) and marionette (mouth-to-chin) lines, as well as lip augmentation, crm-DX, targeted at volume replacement for tissue augmentation of the cheek or facial contours, crm-GEL, for medium to deep wrinkles and folds plus lip augmentation, crm-DUR, designed to treat superficial lines and wrinkles such as those around the eyes and mouth and crm-SOFT aimed at biorejuvenation using a mesotherapy technique.

As well as the hyaluronic acid base, both crm-DEX and crm-DX designed for volume replacement, deep folds and facial contouring also contain dextranomeres (dextran molecules) at 25 and 50 mgs respectively. These are positively charged microspheres that aim to stimulate the tissue to produce new collagen and help the regeneration of the tissue in the area treated.

Clinical Results


Before treatment with 1ml crm- DUR and 2ml crm-GEL	1 week after treatment with CRM® dermal fillers	3 months after treatment with CRM® dermal fillers


Before treatment with 1ml crm- DEX and 0.5ml crm-DUR	3 months after treatment with CRM® dermal fillers	6 months after treatment with CRM® dermal fillers

Photographs courtesy of Medical Aesthetic Group.

(Before and after photographs are real patients, your results may differ).

CRM® Information and Background

Product Summary

The German company behind Matridur and Matridex have now launched a new range of non-animal hyaluronic acid based fillers under the brand name CRM®, which relates to their Covalent Reticulated Copolymer Matrix technology.

This has now been available in the UK since March 2008. As a result, you may only come across a few practitioners using this product currently.

Generic name

Non-Animal Hyaluronic Acid (NaHA) gel.

Plus positively charged dextranomeres within two products (see product range details below for more information).

How is it made?
Hyaluronic acid - by bacterial fermentation from streptococci bacteria.

Is a skin test required before treatment?
No.

Is it temporary or permanent?
Hyaluronic acid is completely broken down within the skin over a period of months, eventually leaving no trace of the filler.

Dextranomeres or dextran molecules break down into sugars within 2 years.

Licenced status
Medical device.

European CE mark approved.

Should be used by
Trained members of the medical profession only.

Product range

crm-DEX™

17mg/ml of hyaluronic acid and 25mg/ml of dextranomeres used for treating deep wrinkles and folds such as glabellar (frown), nasolabial (nose-to-mouth) and marionette (mouth-to-chin) lines, as well as lip augmentation.

1 x 1ml syringes with a 27 gauge needle.

crm-DX™

17mg/ml of hyaluronic acid and 50mg/ml of dextranomeres targeted at volume replacement for tissue augmentation of the cheek or facial contours.

1 x 1ml syringes with a 27 gauge needle.

As well as the hyaluronic acid base, both crm-DEX and crm-DX, designed for volume replacement, deep folds and facial contouring also contain dextranomeres (dextran molecules) at 25 and 50 mgs respectively. These are positively charged microspheres that aim to stimulate the tissue to produce new collagen and help the regeneration of the tissue in the area treated.

crm-GEL™

4mg/ml of pure hyaluronic acid and 16mg/ml of cross-linked hyaluronic acid used for medium to deep wrinkles and folds, plus lip augmentation.

1 x 1ml syringes with a 29 gauge needle.

crm-DUR™

14mg/ml of cross-linked hyaluronic acid designed to treat superficial lines and wrinkles such as those around the eyes and mouth.

1 x 1ml syringes with a 30 gauge needle.

crm-SOFT™

14mg/ml of hyaluronic acid aimed at biorejuvenation or skin rehydration of the face, neck, décolletage and backs of the hands using a mesotherapy technique.

1 x 1ml syringes with a 30 gauge needle.

Not to be used in
Individuals with a known hypersensitivity to hyaluronic acid or an auto-immune disease.

Pregnancy and breast feeding.

Patients who have a tendency to develop hypertrophic scars.

Duration of effect
This depends upon the degree of correction required, your age and lifestyle as well as the correct placement of the product by a practitioner.

According to the manufacturers hyaluronic acid only products (crm-GEL, crm-DUR and crm-SOFT) are expected to last between 4 to 9 months depending on the area treated and the specific product used. The two other products, crm-DX and crm-DEX which contain dextranomeres are said to last 12 -18 months.

Reported side effects
Transient erythema (redness), swelling, pain, itching, discolouration or tenderness at the implant site. Typically resolution is spontaneous, within one or two days after injection into the skin, and within a week after injection into the lips.

Any persistent reaction must be reported to your practitioner.

Localised reactions thought to be of a hypersensitivity nature have been reported.

In rare cases granuloma formation (which show up as red lumps underneath the skin and may be permanent) can occur.

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