Global Facial Rejuvenation Using a New Cohesive, Highly Concentrated Hyaluronic Acid Filler: A Descriptive Analysis of 35 Cases (original) (raw)
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2010
BACKGROUND The new 20 mg/mL hyaluronic acid (HA) dermal filler is a smooth, highly cohesive, viscous formulation developed to restore volume in aesthetic facial rejuvenation. OBJECTIVE Evaluate clinical experience with 20 mg/mL HA dermal filler to date and comment on its current and potential uses within the facial rejuvenation treatment paradigm. METHODS AND MATERIALS In this paper, the authors review the unique physical and chemical properties of 20 mg/mL HA dermal filler as well as clinical experience with the product to date. RESULTS Overall, the 20 mg/mL smooth, cohesive, viscous HA filler was especially effective in restoring volume in the malar region and chin. Volume loss resolved significantly in patients in clinical trials1 and treatment effects were observed to be maintained from six to 18 months.2 Physicians reported the agent was highly effective as well as easy to inject, sculpt and mold. The treatment was generally well tolerated and no instances of product migration ...
Clinical, Cosmetic and Investigational Dermatology
Injectable hyaluronic acid-based fillers are commonly used for the correction of skin contour irregularities and to smooth skin depressions formed by volume loss during the aging process. These fillers are particularly efficient to restore perioral skin depressions/wrinkles or to correct topographical anomalies. The European directives require a continuous evaluation of the performance of these medical devices, particularly for CE marked products. Methods: An 18-month prospective randomized single-blind study for the efficacy and safety of ART FILLER Universal (AFU) was performed on the lips, the nasolabial folds, and the marionettes lines. The evaluations were performed on 153 subjects enrolled in this study. The efficacy, the longevity, and the safety were evaluated for the injected areas via area specific clinical scoring after a single injection with the filler and with no re-touch. Results: We showed here that filler injection induced potent improvements of volume restoration after a single injection on all the treated areas. These beneficial properties of the filler were significant 3 weeks after injection and during the whole study period. Moreover, injections of the filler were well tolerated by the subjects. The recorded adverse events are routinely seen with HA fillers for face volume corrections, and most of these local reactions resolved within 14 days. Conclusion: AFU was well tolerated and showed a continuous efficacy for at least 18 months, in exploratory analyses.
Hyaluronic acid in the rejuvenation of the upper third of the face: review and update - Part 1
Surgical & Cosmetic Dermatology, 2016
In recent years there has been a breakthrough in non-invasive techniques of facial rejuvenation. The greater understanding of the anatomical changes involved in the aging process was accompanied by rapid evolution in how to address these changes and the expansion of substances and technologies used in this approach. Of the arsenal of substances used for rejuvenation, the upper third of the face was before an almost exclusive territory of neuromodulators. Currently, fillers have stood out, especially those based onhyaluronic acid (HA), because they are safe and produce immediate and lasting-but reversible-results.The objective of this first article is to provide a brief literature review and update on the use of HA fillers in the rejuvenation of the upper third of the face, focusing on the forehead and glabella areas.
Skin Remodeling Using Hyaluronic Acid Filler Injections in Photo-Aged Faces
Dermatologic Surgery, 2016
BACKGROUND Hyaluronic acid (HA) filler is an important dermatological procedure. Although many studies have reported clinical improvement with this procedure, histology with morphometric evidence is not well documented. OBJECTIVE To evaluate the clinical and histological results of a HA filler injection and to quantify dermis remodeling at 3 and 9 months after HA injections into aged faces. MATERIALS AND METHODS Twenty patients were enrolled in this study. Hyaluronic acid filler was injected into the nasolabial folds and preauricular regions of the patients. Skin biopsies of the preauricular regions were performed before the procedure and at 3 and 9 months after the procedure. RESULTS Sixteen women (aged 40-50 years) completed the clinical study and demonstrated improvement for 12 months. Twenty patients completed the histologic studies. Morphologic evaluation showed increases in the epidermal layers. The morphometric study showed a statistically significant increase in collagen fibers at 3 and 9 months after the procedure (34.2% 6 31.5% and 39.5% 6 39.7%, respectively, p < .05). CONCLUSION Sustained clinical results for HA filler can be explained not only by the presence of HA gel on the dermis but also by the dermal remodeling induced by HA filler injected into the face. Allergan Pharmaceuticals supported the histopathological studies and donated the HA filler used in the study procedures. F. B. Franç a Wanick is an Allergan speaker in Brazil. The authors have indicated no significant interest with commercial supporters.
Clinical, Cosmetic and Investigational Dermatology
Background: As the treatment indications for the Cohesive Polydensified Matrix ® hyaluronic acid (CPM-HA) portfolio continue to expand and diversify, injectors new to the range or those who are expanding the treatments they offer may be unsure of the optimal product and injection technique for specific facial areas. Each product in the CPM-HA portfolio has been intentionally designed to provide the best physical properties for a specific indication and target tissue. This document has been developed to provide a comprehensive, one-stop reference for clinicians using the portfolio. Methods: An international panel of experts in the field of aesthetic medicine convened to develop guidelines on effective and safe injection technique when performing treatments with the CPM-HA range of soft-tissue fillers. Results: Consensus members considered treatment indications in the upper, middle and lower face. Landmark deficiencies and anatomical considerations are described for each indication and consensus recommendations provided on the optimal product, injection depth and treatment technique. This is supplemented by the experts advice on avoidance of complications. Throughout, an evidence-based approach to selection of products and injection techniques is provided. The result is a fully tailored approach to a range of indications covering the full portfolio of CPM-HA products, including the newest addition for skin revitalization. Conclusion: The recommendations in this consensus document are provided to assist clinicians in the selection of CPM-HA products, administration techniques and depths of injection with the aim of providing seamless and natural treatment results, enhanced safety and patient satisfaction.
Comparative Physical Properties of Hyaluronic Acid Dermal Fillers
Dermatologic Surgery, 2009
BACKGROUND Hyaluronic acid (HA) fillers are becoming the material of choice for use in cosmetic soft tissue and dermal correction. HA fillers appear to be similar, but their physical characteristics can be quite different. These differences have the potential to affect the ability of the physician to provide the patient with a natural and enduring result. OBJECTIVE The objective of this article is to discuss the key physical properties and methods used in characterizing dermal fillers. These methods were then used to analyze several well-known commercially available fillers. METHODS AND MATERIALS Analytical methods were employed to generate data on the properties of various fillers. The measured physical properties were concentration, gel-to-fluid ratio, HA gel concentration, degree of HA modification, percentage of cross-linking, swelling, modulus, and particle size. RESULTS The results demonstrated that commercial fillers exhibit a wide variety of properties. CONCLUSION Combining the objective factors that influence filler performance with clinical experience will provide the patient with the optimal product for achieving the best cosmetic result. A careful review of these gel characteristics is essential in determining filler selection, performance, and patient expectations.
Dermatologic Surgery, 2019
BACKGROUND Three new hyaluronic acid (HA)-based fillers made of long chains crosslinked with reduced amounts of 1,4-butanediol diglycidyl ether (BDDE) were developed for the treatment of dynamic facial areas. Their resilience and increased stretching ability were optimized to ease injectors' practice and provide patients with most natural aesthetic results. OBJECTIVE This study aimed at evaluating the efficacy, durability, and safety of these resilient HA fillers versus commercially available comparator gels. METHODS A prospective, monocentric, split-face, double-blinded, randomized, controlled trial was performed on 90 subjects presenting moderate to severe bilateral nasolabial folds (NLFs). Efficacy parameters were assessed over 18 months, including improvement on the Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale, as well as quantitative imaging and analysis of NLF correction. Physicians' and subjects' satisfaction, together with safety, were assessed throughout the study. RESULTS The new HA fillers offered efficacy and safety profiles at least equivalent to comparators. These dynamic facial fillers elicited higher satisfaction immediately after injection but also on the long run, according to both investigators and subjects. CONCLUSION This pilot trial demonstrated the numerous benefits of 3 new resilient HA fillers with decreased BDDE crosslinking in the treatment of dynamic wrinkles. Materials and funding for this study were provided by TEOXANE Laboratories. Berthold Rzany is a consultant for Merz Aesthetics. The other authors do not report any conflicts. M aintaining a youthful, healthy, and natural appearance while aging fuels the social interactions and quality of life. 1 Minimally invasive fillers for soft-tissue augmentation are among the most widespread aesthetic treatments for facial rejuvenation, and hyaluronic acid (HA)-based fillers have become the second most popular nonsurgical aesthetic procedure. 2-4 For each indication, optimal outcomes require a specific injection technique but also selecting the right HA filler. To preserve a natural expressiveness of emotions, injectables must adapt to facial dynamics like native soft tissues. 3,4 Hence, selecting fillers with appropriate rheological properties is key to achieve natural-looking and durable aesthetic results. These will determine gel performances when exposed to diverse mechanical stresses in various facial areas. 5 For many injectables, gel stabilization is ensured by chemically crosslinking HA polymers with
Dermatologic Surgery, 2019
BACKGROUND Three new hyaluronic acid (HA)-based fillers made of long chains crosslinked with reduced amounts of 1,4-butanediol diglycidyl ether (BDDE) were developed for the treatment of dynamic facial areas. Their resilience and increased stretching ability were optimized to ease injectors' practice and provide patients with most natural aesthetic results. OBJECTIVE This study aimed at evaluating the efficacy, durability, and safety of these resilient HA fillers versus commercially available comparator gels. METHODS A prospective, monocentric, split-face, double-blinded, randomized, controlled trial was performed on 90 subjects presenting moderate to severe bilateral nasolabial folds (NLFs). Efficacy parameters were assessed over 18 months, including improvement on the Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale, as well as quantitative imaging and analysis of NLF correction. Physicians' and subjects' satisfaction, together with safety, were assessed throughout the study. RESULTS The new HA fillers offered efficacy and safety profiles at least equivalent to comparators. These dynamic facial fillers elicited higher satisfaction immediately after injection but also on the long run, according to both investigators and subjects. CONCLUSION This pilot trial demonstrated the numerous benefits of 3 new resilient HA fillers with decreased BDDE crosslinking in the treatment of dynamic wrinkles. Materials and funding for this study were provided by TEOXANE Laboratories. Berthold Rzany is a consultant for Merz Aesthetics. The other authors do not report any conflicts. M aintaining a youthful, healthy, and natural appearance while aging fuels the social interactions and quality of life. 1 Minimally invasive fillers for soft-tissue augmentation are among the most widespread aesthetic treatments for facial rejuvenation, and hyaluronic acid (HA)-based fillers have become the second most popular nonsurgical aesthetic procedure. 2-4 For each indication, optimal outcomes require a specific injection technique but also selecting the right HA filler. To preserve a natural expressiveness of emotions, injectables must adapt to facial dynamics like native soft tissues. 3,4 Hence, selecting fillers with appropriate rheological properties is key to achieve natural-looking and durable aesthetic results. These will determine gel performances when exposed to diverse mechanical stresses in various facial areas. 5 For many injectables, gel stabilization is ensured by chemically crosslinking HA polymers with