Minimally invasive tissue support

Abstract

Embodiments of apparatus and methods for tissue lifting, or for correcting a ptosis condition caused by tissue stretching, are described. In some embodiments a tissue is supported by a support member. In some embodiments, tension is applied to a support member through at least one suspension member. The described embodiments provide examples of methods and apparatus effective for use in lifting or otherwise applying tension to various tissues, including tissues of the breast, buttock, thigh, arm, abdomen, neck and face.

1 . A device, for use in supporting a tissue in a patient's body, comprising; 
 a support member, adapted to engage at least a portion of a tissue, the support member comprising a first end and a second end, the support member further comprising a plurality of support elements; and    first and second suspension members, the first suspension member being coupled to the first end of the support member, the second suspension member being coupled to the second end of the support member;    wherein at least one of the first and second suspension members is configured to be secured to a location in the patient's body;    wherein the plurality of support elements is configured to distribute a load, from the tissue engaged by the support member, imposed on the support member; and    wherein at least one of the first and second suspension members is configured to transmit a force through the support member, the force effective to move the engaged portion of the tissue from a first position to a second position.    
     
     
         2 . The device of  claim 1 , wherein the first suspension member is coupled to each support element at a first end of each support element, and the second suspension member is coupled to each support element at a second end of each support element.  
     
     
         3 . The device of  claim 1 , wherein the second position is superior to the first position.  
     
     
         4 . The device of  claim 1 , wherein the second position is at least one of posterior, medial, and lateral, relative to the first position.  
     
     
         5 . The device of  claim 1 , wherein the second position is posterior to the first position.  
     
     
         6 . The device of  claim 1 , wherein each of the plurality of support elements is elongate and has a length extending along an arc, or line, that extends between the first end of the support member and the second end of the support member; 
 wherein a first of the plurality of support elements is spaced apart from a second of the plurality of support elements along at least about 10% of a length of the first of the plurality of support elements; and    wherein the length of the plurality of support elements extends from the first end of the support member to the second end of the support member.    
     
     
         7 . The device of  claim 1 , wherein a first of the plurality of support elements is spaced apart from a second of the plurality of support elements along at least about 30% of a length of the first of the plurality of support elements; and 
 wherein the length of the plurality of support elements extends from the first end of the support member to the second end of the support member.    
     
     
         8 . The device of  claim 1 , wherein at least one of the support elements is fusiform shaped.  
     
     
         9 . The device of  claim 1 , wherein at least one suspension member is configured to be secured to at least one of muscle, fascia, bone, ligament, tendon, and skin.  
     
     
         10 . The device of  claim 1 , wherein the portion of the tissue being engaged comprises at least one of breast tissue, buttock tissue, facial tissue, arm tissue, abdominal tissue, and leg tissue.  
     
     
         11 . The device of  claim 1 , wherein each support element comprises at least one of an elongate member and a mesh.  
     
     
         12 . The device of  claim 1 , wherein each of the plurality of support elements is coupled to a separator, effective to maintain spacing between adjacent support elements.  
     
     
         13 . The device of  claim 1 , wherein the support member comprise an engagement member, effective to limit movement of the support member relative to the engaged portion of the tissue.  
     
     
         14 . The device of  claim 13 , wherein the engagement member comprises at least one of a barb, a hook, and a suture.  
     
     
         15 . The device of  claim 1 , wherein at least a portion of the device comprises a biodegradable material.  
     
     
         16 . The device of  claim 1 , further comprising a coating effective to enhance at least one of biocompatibility and healing.  
     
     
         17 . A device, for use in supporting a tissue in a patient's body, comprising; 
 a support member, adapted to engage at least a portion of a tissue, the support member comprising a first end, a second end, and an inflatable portion therebetween; 
 wherein, upon inflation, the inflatable portion is effective to increase an apparent volume of the tissue;  
   first and second suspension members, the first suspension member being coupled to the first end of the support member, and the second suspension member being coupled to the second end of the support member;    wherein at least one of the first and second suspension members is configured to be secured to a location in the patient's body;    wherein the support member is configured to distribute a load imposed on the support member from the tissue engaged by the support member; and    wherein at least one of the first and second suspension members is configured to transmit a force through the support member, the force effective to move the engaged portion of the tissue from a first position to a second position.    
     
     
         18 . The device of  claim 17 , wherein the second position is superior to the first position.  
     
     
         19 . The device of  claim 17 , wherein the second position is at least one of posterior, medial, and lateral, relative to the first position.  
     
     
         20 . The device of  claim 17 , wherein the tissue being supported comprises at least one of breast tissue, buttock tissue, facial tissue, arm tissue, abdominal tissue, and leg tissue.  
     
     
         21 . The device of  claim 17 , wherein the inflatable portion comprises pleats.  
     
     
         22 . The device of  claim 17 , further comprising a port for inflating the inflatable portion.  
     
     
         23 . The device of  claim 22 , wherein the port is in or on at least one of the suspension members.  
     
     
         24 . A device, for use in supporting tissue, comprising; 
 a support member, adapted to engage at least a portion of a tissue, the support member comprising a first end and a second end; 
 wherein the support member is configured to distribute a load imposed on the support member from the tissue engaged by the support member; and  
   first and second suspension members, the first suspension member being coupled to the first end of the support member and the second suspension member being coupled to the second end of the support member;    wherein at least one suspension member is configured to be secured to a location at least about 5 cm away from the engaged portion of the tissue;    wherein at least one of the first suspension member, the second suspension member, and the support member comprises an elastic element;    wherein at least one of the first and second suspension members is configured to transmit a force through the support member, the force effective to move the engaged portion of the tissue from a first position to a second position; and    wherein the elastic element is configured to permit movement of the engaged portion of the tissue from the second position toward the first position.    
     
     
         25 . The device of  claim 24 , wherein the second position is superior to the first position.  
     
     
         26 . The device of  claim 24 , wherein the second position is at least one of posterior, medial, and lateral, relative to the first position.  
     
     
         27 . The device of  claim 24 , wherein the portion of the tissue being engaged comprises at least one of breast tissue, buttock tissue, facial tissue, arm tissue, abdominal tissue, and leg tissue.  
     
     
         28 . The device of  claim 24 , wherein the elastic element comprises at least one of an elastomeric core and an elastomeric cover.  
     
     
         29 . The device of  claim 24 , wherein the elastic element comprises a spring.  
     
     
         30 . The device of  claim 24 , wherein the at least one suspension member comprises a braided portion.  
     
     
         31 . The device of  claim 24 , wherein at least a portion of the elastic element has a nonlinear elastic constant.  
     
     
         32 . The device of  claim 24 , further comprising a channel member through which at least a portion of a suspension member passes, when the device is implanted in the body; 
 wherein the channel member is configured to limit contact of surrounding tissue by the portion of the suspension member.    
     
     
         33 . The device of  claim 32 , wherein the channel member is tubular.  
     
     
         34 . A device, for use in supporting a tissue in a patient's body, comprising; 
 a support member, adapted to engage at least a portion of a tissue, the support member comprising a first end and a second end; 
 wherein the support member is configured to distribute a load imposed on the support member from the tissue engaged by the support member;  
   first and second suspension members, the first suspension member being coupled to the first end of the support member, and the second suspension member being coupled to the second end of the support member; and    a disconnect member, configured to release tension in the suspension member when a load on the device exceeds a threshold load;    wherein at least one of the suspension members is configured to be secured to a location in the patient's body; and    wherein at least one of the suspension members is configured to transmit a force through the support member, the force effective to move an engaged portion of the tissue of the patient from a first position to a second position.    
     
     
         35 . The device of  claim 34 , wherein the second position is superior to the first position.  
     
     
         36 . The device of  claim 34 , wherein the second position is at least one of posterior, medial, and lateral, relative to the first position.  
     
     
         37 . The device of  claim 34 , wherein the portion of the tissue being engaged comprises at least one of breast tissue, buttock tissue, facial tissue, arm tissue, abdominal tissue, and leg tissue.  
     
     
         38 . The device of  claim 34 , wherein the disconnect member is configured to separate a first portion of at least one of the suspension members from a second portion of the at least one of the suspension members in response to the load that exceeds the threshold.  
     
     
         39 . The device of  claim 34 , wherein the disconnect member is configured to separate at least one of the suspension members from the support member in response to the load that exceeds the threshold.  
     
     
         40 . A device, for use in supporting a tissue in a patient's body, comprising: 
 an elongate suspension member, having a first end and a second end, and a length extending therebetween; 
 wherein the suspension member is configured to engage, and exert traction on, a tissue, resulting in the tissue moving from a first position to a second position;  
 wherein at least a portion of suspension member is configured to shorten along the length of the suspension member in response to delivery of an energy to the suspension member;  
 wherein the suspension member further comprises at least one engagement member, configured to engage at least a portion of the tissue;  
   an elongate energy delivery member, coupled to at least a portion of the suspension member; 
 wherein at least a portion of the elongate energy delivery member extends alongside at least a portion of the length of the suspension member; and  
 wherein the elongate energy delivery member is configured to deliver the energy to the suspension member.  
   
     
     
         41 . The device of  claim 40 , wherein the energy comprises at least one of electromagnetic energy, acoustic energy, and thermal energy.  
     
     
         42 . The device of  claim 40 , wherein the at least a portion of the elongate suspension member comprises collagen.  
     
     
         43 . The device of  claim 40 , wherein the at least a portion of the elongate suspension member comprises at least one of a shape memory alloy and a shape memory polymer.  
     
     
         44 . The device of  claim 40 , wherein the at least a portion of the elongate suspension member comprises a swellable material.  
     
     
         45 . The device of  claim 44 , wherein the swellable material comprises a hydrogel.  
     
     
         46 . The device of  claim 40 , wherein the at least a portion of the elongate suspension member comprises a braid.  
     
     
         47 . A method, for supporting a breast in a body of a patient, comprising: 
 providing a supporting device having a first end, a second end, and a support member positioned between the first end and second end;    advancing the first end of the supporting device into a breast, through a first incision that is located on one of a medial and a lateral side of the breast;    withdrawing the first end of the supporting device from the breast through a second incision, located on the other of the medial and the lateral side of the breast, until the support member is positioned within breast tissue between the first incision and second incision;    advancing the first end of the supporting device, from a position within the breast adjacent the second incision, to a first location, and the second end of the supporting device, from a position within the breast adjacent the first incision, to a second location; 
 wherein both of the first and second locations are superior to the first and second incisions;  
   drawing the breast tissue toward the first and second locations; and    anchoring the first and second ends of the supporting device at the first and second locations, respectively.    
     
     
         48 . The method of  claim 47 , wherein the first and second locations are substantially the same location.  
     
     
         49 . The method of  claim 47 , further comprising coupling a portion of the first end to a portion of the second end, inside the body.  
     
     
         50 . The method of  claim 47 , wherein anchoring comprises coupling the first and second ends to at least one of bone, muscle, fascia, tendon, ligament, and skin.  
     
     
         51 . A method, for supporting a tissue in a body of a patient, comprising: 
 placing a supporting device into the body, the supporting device comprising: 
 a support member, adapted to engage at least a portion of a tissue, the support member comprising a first end and a second end;  
 wherein the support member is configured to distribute a load imposed on the support member from the tissue engaged by the support member;  
 at least one suspension member coupled to the support member;  
   engaging the at least a portion of the tissue with the support member;    applying tension to the at least one suspension member, thereby moving the engaged portion of the tissue from a first position to a second position;    securing the at least one suspension member to a location in the body, such that the engaged portion of the tissue is effectively maintained in the second position; and    inflating at least a portion of the supporting device to increase an apparent volume of the tissue.    
     
     
         52 . The method of  claim 51 , wherein the portion of the tissue being engaged comprises at least one of breast tissue, buttock tissue, facial tissue, arm tissue, abdominal tissue, and leg tissue.  
     
     
         53 . A method, for supporting a tissue in a body of a patient, comprising: 
 placing a supporting device into the body, the supporting device comprising: 
 a support member, adapted to engage at least portion of a tissue, the support member comprising a first end and a second end; 
 wherein the support member is configured to distribute a load imposed on the support member from the tissue engaged by the support member; and  
 
 at least one suspension member coupled to the support member;  
   placing the support member so as to effectively engage at least a portion of the tissue;    applying tension to the at least one suspension member, thereby moving the engaged portion of the tissue from a first position to a second position;    securing the at least one suspension member to a location in the body, such that the engaged portion of the tissue is effectively maintained substantially in the second position; and    wherein the supporting device is configured, in response to a load that exceeds a threshold, to release tension in the at least one suspension member.    
     
     
         54 . The device of  claim 53 , wherein the supporting device is configured to uncouple a first portion of at least one of the suspension members from a second portion of the at least one of the suspension members in response to the load that exceeds the threshold.  
     
     
         55 . The device of  claim 53 , wherein the supporting device is configured to uncouple at least one of the suspension members from the support member in response to the load that exceeds the threshold.  
     
     
         56 . The method of  claim 53 , wherein the at least one suspension member increases in length when the load exceeds the threshold.  
     
     
         57 . A method, for use in supporting breast tissue in a patient's body, comprising: 
 providing a support member, adapted to engage breast tissue, the support member comprising a first end and a second end; 
 wherein the support member is configured to distribute a load imposed on the support member from the breast tissue engaged by the support member; and  
   providing first and second suspension members, the first suspension member being coupled to the first end of the support member and the second suspension member being coupled to the second end of the support member;    wherein, when implanted, the first suspension member, extends superiorly from the first end of the support member, and the second suspension member, extends superiorly from the second end of the support member;    anchoring the first suspension member at a first location, and the second suspension member at a second location;    wherein the first and second locations are located superiorly to the engaged breast tissue;    wherein a distance between the first and second locations is greater than a greatest distance between the first and second ends of the support member.    
     
     
         58 . A method, for use in supporting a tissue in a patient's body, comprising: 
 providing an elongate suspension member, having a first end and a second end, and a length extending therebetween; 
 wherein the suspension member is configured to engage, and exert traction on, a tissue, resulting in the tissue moving from a first position to a second position;  
 wherein at least a portion of suspension member is configured to shorten along the length of the suspension member in response to delivery of an energy to the suspension member;  
 wherein the suspension member further comprises at least one engagement member, configured to engage at least a portion of the tissue;  
   providing an elongate energy delivery member, coupled to at least a portion of the suspension member; 
 wherein at least a portion of the energy delivery member extends alongside at least a portion of the length of the suspension member; and  
   wherein the energy delivery member is configured to deliver the energy to the suspension member;    delivering the energy to the energy delivery member, thereby shortening the suspension member.    
     
     
         59 . The method of  claim 58 , wherein delivering energy comprises delivering at least one of electromagnetic energy, acoustic energy, and thermal energy.