Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

The Use of Cross-Linked Hyaluronic Acid in Non-surgical Rhinoplasty Using Italian Technique

INTRODUCTION

Projection and upper rotation to the tip is fundamental in the nasal rejuvenation, as a matter of fact the tip is the most important and has strongly effects on the improve appearance and quality of life. The aim of the present study was to evaluate reshaping the tip of the nose by cross-linked hyaluronic acid using Italian technique.

METHODS

In a period between November 2019 and 2023, a total of one hundred and forty healthy, 95 females and 45 man patients, were performed with a mean age 44±5 (age range: 31-52 years old) affected by tip of congenital (22) or ageing nose hypotonia (118), and reduced volume that need of an elevation of the nose tip. The anatomic markers have been considered for the anthropometric measurements after the filler rhinoplasty. Two infiltrations were performed, one in the infiltration into the antero-caudal access over the columella produce upward rotation of the tip of the nose and second infiltration into the antero-superior access produce the projection of the tip of the nose. Medical device used in the study was Neofound STRUCT LIDO (LOVE COSMEDICAL srls-Via Toniolo 9, 57022 Castagneto Carducci, ITALY) containing sodium hyaluronate/hyaluronic acid high molecular weight (1.500

RESULTS

The effect on the upward rotation of the tip nose was evaluated using Global Aesthetic Improvement Scale and morphometric evaluation. All the subjects showed at least 2-3 grade improvement in GAIS score after HA filler injection. The analysis of patient satisfaction after the last follow-up visits clearly demonstrated good results. A significant morphometric difference was detected comparing the T0 and T90 (p<0,0001), while no difference was present comparing T90 and T180 means (p=0.11). The outcome of the present clinical study gives greater projection and upper rotation to the tip with great gratification of the patients and the surgeon. An augmentation of the tip nose with hyaluronic acid filler produces a rejuvenation of the nose area resulted in a more youthful appearance. No adverse event was observed. In 35 patients, additional HA infiltration had to be performed after 2 weeks.

CONCLUSION

In conclusion, the Italian technique descripted in the present paper is safe, simply, and efficacious for rejuvenation of the nose, with elevated levels of patient satisfaction.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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Key Words

• Aesthetic
• Filler
• Hyaluronic acid
• Non-surgical rhinoplasty
• Nose reshaping
• Rhinofiller
• Rhinoplasty

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MESH Headings

• Humans
• Hyaluronic Acid/administration & dosage
• Female
• Rhinoplasty/methods
• Adult
• Male
• Middle Aged
• Italy
• Dermal Fillers/administration & dosage
• Treatment Outcome
• Nose/surgery
• Rejuvenation
• Quality of Life
• Patient Satisfaction/statistics & numerical data
• Esthetics

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Grants

• Università degli Studi G. D'Annunzio Chieti Pescara

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Affiliation(s)

Antonio Scarano Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy.
Andrea Sbarbati Department of Neurosciences, School of Medicine, Biomedicine and Movement Sciences, Anatomy and Histology Section, University of Verona, Verona, Italy
Domenico Amuso Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Chieti, Italy
Roberto Amore Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Chieti, Italy
Segio Rexhep Tari Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
Iris Alla Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy

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Rheological Investigation as Tool to Assess Physicochemical Stability of a Hyaluronic Acid Dermal Filler Cross-Linked with Polyethylene Glycol Diglycidyl Ether and Containing Calcium Hydroxyapatite, Glycine and L-Proline

(1) Background: Dermal fillers are commonly used in aesthetic practice and their rheological characterization is of much interest today, as well as the stability study of the finished formula against external stimuli of a different nature (biological and physicochemical). Rheological tools have been exploited to characterize the physiochemical behaviour of a hyaluronic acid (HA) based dermal filler subjected to different thermal conditions over time. The collected results provide an index of its rheological stability. (2) Methods: After a preliminary Amplitude sweep test, the Frequency sweep test was performed in order to study the stability of a HA dermal filler cross-linked with Polyethylene Glycol Diglycidyl Ether (PEGDE) and containing Calcium Hydroxyapatite (CaHA), Glycine and L-Proline subjected to different conditions. Also, a shear rate ramp test was performed in order to investigate the filler’s flow behavior. (3) Results and Conclusions: G’ (elastic modulus), G’’ (viscous modulus) and consequentially tan δ (tangent of the phase angle) show a similar trend at different thermal conditions, underlining that the product is not affected by the storage conditions. The viscosity of the dermal filler decreases with an increasing shear rate, so a non-Newtonian shear thinning pseudoplastic behavior was demonstrated in all tested conditions.