Evaluation of the Hydrophilic, Cohesive, and Physical Properties of Eight Hyaluronic Acid Fillers: Clinical Implications of Gel Differentiation.

Background: Hyaluronic acid (HA) fillers are used to treat an array of aesthetic indications. Proper filler selection is paramount for successful patient outcomes. However, many important physiochemical and physical properties that impact HA gel behavior remain undefined. Purpose: To evaluate the hydrophilicity, cohesivity and particle size of eight commercial HA fillers manufactured by either Non-Animal Stabilized Hyaluronic Acid (NASHA) or Optimal Balance Technology (OBT) techniques. Methods and Materials: Three individual in vitro experiments were performed to assess HA swelling capacity, cohesion, and particle size. Image analyses, blinded evaluation using the Gavard-Sundaram Cohesivity Scale, and laser diffraction technology were utilized, respectively. Results: Compared to fillers manufactured with NASHA technology, OBT products demonstrated greater swelling capacity, cohesion, and wider particle size distributions. Strong positive correlations between swelling factor, degree of cohesivity, and increasing widths of the particle size distributions were observed. Conclusions: The hydrophilicity, cohesivity and particle size distributions vary among HA fillers manufactured with different techniques. The creation of new labels identifying products based on their unique combination of physiochemical and physical characteristics may help guide appropriate selection of HA fillers to optimize patient outcomes.

A Retrospective Analysis of Patient Satisfaction With a Graft-Based Non-Surgical Rhinoplasty Procedure Using a Modified Surgical Rhinoplasty Module.

Non-surgical rhinoplasty, also known as liquid or injection rhinoplasty, utilizes hyaluronic acid-based fillers to offer a minimally invasive alternative to surgical rhinoplasty. Patient goals for injection rhinoplasty include improving various aspects of their nose, including the bridge of the nose, tip of the nose, shape of the nose in profile, and how well the nose suits the face. The purpose of this study is to use a modified surgical rhinoplasty questionnaire to analyze patient satisfaction and adverse complication rates of the authors' non-surgical injection rhinoplasty technique using a hyaluronic acid-based filler. A retrospective data analysis of 56 patients who had received a graft-based non-surgical rhinoplasty procedure between January 2019 and December 2019 was conducted. All procedures were performed at a single center by the primary investigator. Participants completed a questionnaire to assess for preoperative and postoperative satisfaction with their nose using a visual analog scale and modified "FACE-Q" module. Two-tailed paired t-tests and confidence intervals were calculated using bootstrapping/resampling techniques. Visual analog scale results depict a paired median difference of 4, yielding a P-value of 0.00001. Results illustrate that using a graft-based non-surgical rhinoplasty technique presents a promising alternative to surgical rhinoplasty that significantly improves patient satisfaction with their nose while ensuring minimal complication rates. Over 98% of patients indicated feeling "somewhat" or "very likely" to repeat the procedure. J Drugs Dermatol. 2024;23(1):1292-1296.     doi:10.36849/JDD.7073.

Poly-L-Lactic Acid for Gluteal Augmentation found to be Safe and Effective in Retrospective Clinical Review of 60 Patients.

BACKGROUND: Poly-L-lactic acid (PLLA) is a well-established biostimulator that induces neocollagenesis, allowing for volume loss correction. Although PLLA is FDA approved to treat mid-to-lower facial wrinkling, it has grown increasingly popular as a nonsurgical, minimally invasive procedure for soft-tissue volume augmentation of other extremities. However, research detailing PLLA buttock injections is still lacking. OBJECTIVE: The purpose of this study is to determine the safety and efficacy of PLLA for buttock augmentation. MATERIALS AND METHODS: A clinical retrospective review of 60 patients (ages 23-54 years) were followed for 2 years by 2 investigators. Patients underwent 1 to 3 treatments, spaced 4 to 6 weeks apart, and received 2 to 12 vials per session (based on the patient budget). Pretreatment and post-treatment photographs were assessed by the primary and secondary investigator in blinded and double-blinded surveys, respectively. The Global Aesthetic Improvement Scale was used to quantify improvements in volume, skin texture, and cellulite dimpling. RESULTS: Poly-L-lactic acid allows for visible volume amplification, improved skin texture, and softened cellulite dimpling in the buttocks when at least 20 vials are used. CONCLUSION: Poly-L-lactic acid is safe and effective for overall aesthetic enhancement of the buttocks if used in adequate quantity (minimum 20 vials) for all women, independent of age or the number of sessions.