Physical characteristics of hyaluronic acid dermal fillers copy
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This document summarizes the physical characteristics and properties of hyaluronic acid dermal fillers. It discusses that hyaluronic acid is a naturally occurring polysaccharide found in skin that attracts and binds water. The concentration and cross-linking of hyaluronic acid determines the displacement and duration of the filler, with higher concentrations and more cross-linking lasting longer. Particle size varies between fillers, with larger particles for deeper injections and finer lines. Sources can be animal, avian, or bacterial-derived, and lidocaine can be added for comfort during injection.
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Physical characteristics of hyaluronic acid dermal fillers copy
- 2. Hyaluronic Acid Naturally occurring polysaccharide Occurs in extracellular matrix in skin Attracts and binds water Up to 1000x its own weight Activates fibroblasts Inducing formation of collagen Minimal adverse effects
- 4. Concentration of Hyaluronic Acid Increased concentration = Increased displacement Increased concentration = Increased duration Ideal 20mg/g or more
- 5. Cross- Linking of Hyaluronic Acid Described as a % Cross-linking stabilises product Single Double Multi
- 6. Particle size of Hyaluronic Acid Larger particles Deeper injections Larger defects Small particles Finer lines More detail
- 7. Particle size of Hyaluronic Acid Biphasic Different size of particles Monophasic Particles of same size
- 8. Lidocaine Addition to Hyaluronic Acid 0.3% lidocaine addition Comfort in injection Post operative comfort
- 9. Summary Increased viscosity indicated for larger areas Facial recontouring Nasolabial folds Harder to inject Less viscous formulations for finer indications Fine lines Lip augmentation More cross linking increases duration of action
- 10. Examples Restylane Silk Restylane Lyft Refyne Defyne Juvederm VOLUMA VOLBELLA ULTRA (and PLUS with lidocaine)
Editor's Notes
- Adverse effects usually injection related Allergy related to protein if animal derived or sure to cross-linking molecule
- Animal derived from comb of rooster- high risk of allergy as high avian protein content synthetic fermentation of the Staphylococcus equine bacterium
- Described often by viscosity- high/low viscosity Higher viscosity used for deeper injections and larger defects Describes the total mount of hyaluronic acid within the gel and doesn’t necessarily describe the amount cross linked. Free soluble HA can help placement and allows flow but is soluble so it is important to be aware of this when discussing concentration.
- Without cross linking hyaluronic acid is a poor filler as it is readily soluble in the tissues. Cross linking is achieved by the introduction of molecules which bind the polysaccharide chains into large molecules with multiple layers in some cases. Increased level of cross linking increases viscosity and means less resistant to degradation
- Again large particles can affect viscosity, more viscous is easier to fill a larger area.
- Evidence suggests comparable results Suggestion that monophasic particles migrate less
- No evidence to suggest affects longevity of hyaluronic acid or alters properties.
- Viscosity is affected by concentration of HA, level of cross linking and particle size. Modification of these elements can alter properties and allow use in different indications.
- All have different indications- voluma is highly viscous and cross linked and recommended for midface lasting reportedly upto 18m volbella is smoother and for lips, less viscous material but again cross linking reportedly allows retention for upto 1 year Ultra is the mid-range for multiple indications. Again lasts upto 1 year reportedly Restylane® and Restylane-L® are mid range for moderate lines and lips Restylane® Lyft is for mid face in mod-severe wrinkles and in hands! Very viscous Restylane® Silk is for lip augmentation and for correction of perioral wrinkles –less viscous and smoother Restylane® Refyne more robust for lines and wrinkles in lower face Restylane® Defyne even more robust for deeper lines.