1
|
Miotti G, De Marco L, Quaglia D, Grando M, Salati C, Spadea L, Gagliano C, Musa M, Surico PL, Parodi PC, Zeppieri M. Fat or fillers: The dilemma in eyelid surgery. World J Clin Cases 2024; 12:2951-2965. [DOI: 10.12998/wjcc.v12.i17.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/22/2024] [Accepted: 05/11/2024] [Indexed: 06/04/2024] Open
Abstract
The aging of the periocular region has always aroused great interest. A fresh, young, and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result. In particular, the change in the concept of a young look, considered then “full”, led to the increasing use of surgical (fat grafting) or medical (hyaluronic acid) filling techniques. Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments, with a focus on achieving a youthful and refreshed appearance. Among the various techniques available, the choice between using fat grafting or fillers presented a clinical dilemma. In particular, what surgery considered of fundamental importance was a long-lasting result over time. On the other hand, aesthetic medicine considered it fundamental not to have to resort to invasive treatments. But what was the reality? Was there one path better than the other, and above all, was there a better path for patients? The minireview aims to explore the physiopathology, diagnosis, treatment options, prognosis, and future studies regarding this dilemma. We analyzed the literature produced in the last 20 years comparing the two techniques. Current literature reveals advancements in biomaterials, stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation. The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma. Understanding physiopathology, accurately diagnosing eyelid aging, exploring treatment options, assessing prognosis, and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.
Collapse
Affiliation(s)
- Giovanni Miotti
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Luca De Marco
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Davide Quaglia
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Martina Grando
- Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome 00142, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna “Kore”, Enna 94100, Italy
- Eye Clinic Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, Catania 95121, Italy
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin 300283, Nigeria
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
| | - Pier Luigi Surico
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, United States
| | - Pier Camillo Parodi
- Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| |
Collapse
|
2
|
Smith SW, Massey BL, Hall MB, Buckingham ED. A Prospective Open-Label Study for Treatment of Infraorbital Hollows Using a Volumizing Hyaluronic Acid Filler. Facial Plast Surg 2024; 40:363-369. [PMID: 37253385 DOI: 10.1055/a-2102-4796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
This study aimed to prospectively evaluate the effectiveness, patient satisfaction, and early adverse events of using the hyaluronic acid filler VYC-20L for the treatment of infraorbital hollowing. A total of 21 participants underwent injection of VYC-20L. FACE-Q satisfaction surveys before and after treatment along with early adverse events surveys were conducted. Pre- and posttreatment photos were graded, and the Allergan Infraorbital Hollows Scale was used to assess the difference in infraorbital hollowing. The results showed infraorbital hollowing improvement with VYC-20L was significant (p < 0.001). FACE-Q Satisfaction with Eyes scores on average were 27 points higher after treatment (p < 0.001). The mean FACE-Q Satisfaction with Decision score was 74.1%. The most common short-term adverse symptoms were tenderness (67%), swelling (62%), and bruising (52%). This study concludes that VYC-20L is an effective nonsurgical treatment option for infraorbital hollowing with high patient satisfaction.
Collapse
|
3
|
Liu X, Gao Y, Ma J, Li J. The Efficacy and Safety of Hyaluronic Acid Injection in Tear Trough Deformity: A Systematic Review and Meta-analysis. Aesthetic Plast Surg 2024; 48:478-490. [PMID: 37684413 DOI: 10.1007/s00266-023-03613-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/12/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Hyaluronic acid (HA) injection is an effective method to correct tear trough deformity. Nevertheless, the quantitative data of cosmetic results and complications of HA injection in tear troughs remained unemployed. The purpose of this meta-analysis was to synthesize the current quantitative data on the aesthetic outcomes and adverse effects of tear trough deformity correction with HA injection. METHODS This meta-analysis consulted PubMed, Embase, Web of Science, Scopus and Cochrane databases based on the search terms published before September 2022. Data extracted was analyzed to evaluate the satisfaction rates and complications of HA injection. Meta-analysis was performed using the random-effect model for overall and subgroup analysis. RESULTS This meta-analysis comprised 31 reports involving 2556 participants. The pooled overall satisfaction rate was 91.0% (95% CI 84.9-95.7%). The pooled rates of swelling/edema and bruising/ecchymosis were 19.2% (95% CI 10.4-29.9%) and 18.4% (95% CI 10.1-28.4%), respectively. The pooled rates of redness/erythema, contour irregularity/lump and blue discoloration/Tyndall effect were 7.1% (95% CI 1.5-15.6%), 5.3% (95% CI 1.8-10.2%) and 0.9% (95% CI 0.0-2.5%), respectively. CONCLUSIONS The present meta-analysis manifested a low risk of complication rate and a high satisfaction rate in tear trough rejuvenation with HA injection. LEVEL OF EVIDENCE I 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 .
Collapse
Affiliation(s)
- Xuanchen Liu
- Department of Facial and Cervical Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Gao
- Department of Facial and Cervical Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiguang Ma
- Department of Facial and Cervical Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Li
- Department of Facial and Cervical Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
4
|
Dong R, Jin Q, Zhi J, Jin M, Gao Y, Nan M, Jin Z, Jin C. Analysis of the efficacy of blunt separation combined with uncrosslinked sodium hyaluronate composite solution for the treatment of tear trough deformity in Asians. J Cosmet Dermatol 2023. [PMID: 38130178 DOI: 10.1111/jocd.16151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Filling therapy is becoming increasingly popular for correcting tear trough deformities (TTD). However, its therapeutic effect and retention time are limited. AIMS To improve the clinical efficacy and safety of TTD treatment in Asians, we used a blunt separation technique to break the adhesion site of periorbital subcutaneous tissue, and while repairing skin dermis after injury, it was combined with uncrosslinked hyaluronic acid compound solution to promote collagen regeneration and treat TTDs. PATIENTS/METHODS Twenty-six Chinese patients (21 women and 5 men) with TTD, with a mean age of 34.54 ± 9.21 (range, 20-56) years, were enrolled. Symptom improvement, recurrence rates, treatment safety, and patient satisfaction were evaluated. RESULTS All patients' tear trough rating scale (TTRS) scores decreased significantly immediately after treatment. The TTRS scores at 1, 3, and 6 months, and 1 year after treatment demonstrated significant differences from those before treatment (all p < 0.05). All patients' experienced mild pain, erythema, and swelling during the treatment. Three patients developed postinjection bruising after treatment, which lasted for 6-7 days and subsequently disappeared. No other adverse reactions were observed during the follow-up. There were no recurrent cases, and patient satisfaction was very high. CONCLUSIONS Blunt separation combined with an uncrosslinked sodium hyaluronate composite solution is safe and effective for treating TTDs in Asians with few side effects and has good clinical application prospects.
Collapse
Affiliation(s)
- Richeng Dong
- Department of Dermatology, Suzhou Mylike Cosmetic Hospital, Suzhou, Jiangsu, China
| | - Qingmei Jin
- Department of Dermatology, Suzhou Mylike Cosmetic Hospital, Suzhou, Jiangsu, China
| | - Jiahui Zhi
- Department of Dermatology, Suzhou Mylike Cosmetic Hospital, Suzhou, Jiangsu, China
| | - Meilin Jin
- Department of Medical Cosmetology, Yanbian University Hospital, Jilin, China
| | - Yang Gao
- Department of Medical Cosmetology, Yanbian University Hospital, Jilin, China
| | - Meilan Nan
- Department of Medical Cosmetology, Yanbian University Hospital, Jilin, China
| | - Zhehu Jin
- Department of Medical Cosmetology, Yanbian University Hospital, Jilin, China
| | - Chenglong Jin
- Department of Dermatology, Suzhou Mylike Cosmetic Hospital, Suzhou, Jiangsu, China
| |
Collapse
|
5
|
Spada J, Ravera K, Schneider C. Needle versus Cannula to Treat Tear Trough: A Prospective Study Comparing both Methods. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5327. [PMID: 37936826 PMCID: PMC10627584 DOI: 10.1097/gox.0000000000005327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/09/2023] [Indexed: 11/09/2023]
Abstract
Background We aimed to clinically compare needle and cannula techniques in vivo with ultrasound and magnetic resonance imaging, to better understand the best technique and adverse events. Methods Ten adults without previous fillers in the area were injected with hyaluronic acid (CPM 22.5 HA mg/mL) with a 25G cannula on one side and a Becton Dickinson syringe needle (31G 0.3 mL) on the other. The product was fractionated among two visits. Assessment was made at time 0d, 14d, 30d, 60d, 90d, 180d, and 365d with standard camera, Vectra H2, ultrasound, and magnetic resonance imaging. Level of satisfaction was also evaluated. Results All the patients showed natural results with both techniques and a high satisfaction index. Cannulas were minimally less traumatic in terms of bruises. However, the product was applied in a more superficial layer and in a less precise manner, despite the fact that a deep technique was used with cannulas, depositing the product on the orbital bone. Patients reported a more noticeable change immediately after the procedure on the side treated with cannulas but less edema and a more comfortable procedure on the Becton Dickinson syringe treated side. None of the patients required hyaluronidase to dissolve overcorrection of the area, and no severe complications were observed. The product remained in most of them at day 365. Conclusions Cannulas seem to be less traumatic regarding bruises, but less precise in vivo. Thin needles seem to be more precise with minimal trauma. However, this difference disappears during patient's evolution.
Collapse
Affiliation(s)
- Julieta Spada
- From Spada Dermatología y Estética, Buenos Aires, Argentina
| | - Karina Ravera
- Radiology Department, Sanatorio de la Trinidad Mitre, Buenos Aires, Argentina
| | | |
Collapse
|
6
|
Wilde CL, Gupta A, Lee S, Ezra DG. Tear Trough Filler Using the Three-point Tangent Technique: Lessons from 1452 Tear Trough Applications. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5060. [PMID: 37305194 PMCID: PMC10256367 DOI: 10.1097/gox.0000000000005060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/29/2023] [Indexed: 06/13/2023]
Abstract
This study describes a novel three-point tangent technique for tear trough filler and the results from the largest series to date. Methods A retrospective case review was performed for all patients treated between 2016 and 2020. Patient demographics, filler details and complications were recorded. The injection technique involves using a blunt cannula to deliver filler along three linear tangents bespoke to each patient. Results A total of 1452 applications of filler to the orbits of 583 patients were recorded. The median patient age was 41 years (range 19-77), and 84% were women. The mean volume of applied filler at the first appointment was 0.34 mL to each orbit (range 0.1--1.5); 82% reported no complication, 10% reported swelling with a median duration of 4 weeks (range 1-52), 4.3% experienced bruising, 4.6% reported contour irregularities, and 3.3% experienced a Tyndall effect. Retrobulbar hemorrhage occurred in one patient (0.17%), which was managed immediately with no lasting visual compromise. Volume of filler injected was significantly associated with a risk of edema (P < 0.00001) and contour irregularities (P = 0.012). In total, 50% of cases of edema resolved spontaneously after 4 weeks. Filler was dissolved in 1.9% of orbits. Patients with a history of dissolving were significantly more likely to require dissolving after subsequent reinjection (P = 0.043). Conclusions The three-point tangent technique is a safe and effective method. Increasing volume of filler administered is associated with complications of edema and contour irregularities. Edema is the most common complication and resolves spontaneously in half of patients by 4 weeks.
Collapse
Affiliation(s)
- Caroline L. Wilde
- From the Moorfields Eye Hospital NHS Trust, London, United Kingdom
- The Ezra Clinic, London, United Kingdom
| | - Ankur Gupta
- From the Moorfields Eye Hospital NHS Trust, London, United Kingdom
| | - Sieun Lee
- Mental Health & Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
| | - Daniel G. Ezra
- From the Moorfields Eye Hospital NHS Trust, London, United Kingdom
- The Ezra Clinic, London, United Kingdom
| |
Collapse
|
7
|
Diaspro A, Calvisi L, Sito G. Hyaluronic Acid Gel Injection for the Treatment of Tear Trough Deformity: A Multicenter, Observational, Single-Blind Study. Aesthetic Plast Surg 2022; 46:1860-1867. [PMID: 35478038 DOI: 10.1007/s00266-022-02887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/31/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) gel injections were first used to treat the tear trough in 2005 and since then it has been a mainstay of the approach to lower eyelid deformities. OBJECTIVE The authors present this retrospective multicentric observational study based on single-blind objective and subjective evaluation and patient satisfaction in relation to the aesthetic improvement of a large group of patients treated. METHODS AND MATERIALS Between January 2016 and December 2019, 600 patients (468 women and 132 men), were enrolled in this study, and 1200 tear trough deformities were treated with both needle and cannula techniques. RESULTS Average follow-up time was 12 ± 1 months, and the outcomes were assessed both objectively and subjectively with respect to Hirmand's classification. Statistical analysis shows an inverse correlation between age and class amelioration. CONCLUSION HA injection of the tear trough is most effective in patients between 30 and 40 years of age, while its benefits extend to up to 50 years old; afterward, it should no longer be the treatment of choice. This confirms that correction of tear trough with hyaluronic acid injections may provide an option to achieve immediate and durable results for up to one year after the injection. LEVEL OF EVIDENCE IV 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 .
Collapse
|
8
|
Chen R, Yang W, Sun J, Liu Y, An Q, Zhang F, Bai Z, Luan Q. Triple Cross-Linked Hyaluronic Acid Based on Tri-Hyal Technique Has More Durable Effect on Dermal Renewal. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:691-701. [PMID: 35450398 PMCID: PMC9017695 DOI: 10.2147/ccid.s362785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/07/2022] [Indexed: 12/23/2022]
Abstract
Background Hyaluronic acid (HA)-based fillers are applied to treat facial wrinkles and volume loss. Many efforts have been made to improve properties of HA to prolong the duration in aesthetic indications. A new cross-linking technique called “Tri-Hyal”, could make HAs to achieve desired rheological characteristics. HAs synthesized by Tri-Hyal are triple cross-linked and sustained-release, which could increase duration of promoting skin rejuvenation after injection. Purpose To evaluate the efficiency and persistence of HAs with Tri-Hyal on skin rejuvenation and further investigate underlying mechanisms, we compared the performances of cross-linked HA (AF) based on Tri-Hyal with another highly acceptable HA filler (Res) in vivo and in vitro. Methods Male BALB/c mice were divided into three groups, treated with AF, Res and vehicle, respectively. Skin biopsies were taken on day 0, 30, 90 and 180 after injection and hematoxylin and eosin (H&E), Masson’s trichrome (MT), immunohistochemical (IHC) stainings for CD31, TGF-β and MMP9 were performed. EdU incorporation, cell counting kit-8 (CCK-8), SA-β-Gal staining and activity were measured by biochemical analysis. RFP-GFP-LC3 adeno virus was used for autophagic flux detection. Protein levels of CD44, P62 and LC3I/II were detected by Western blot. Reactive oxygen species (ROS) level was detected by flow cytometry with DCFH-DA probe. Results The AF synthesized by Tri-Hyal showed persistent dermal structural correction without attenuation up to 6 months, which was illustrated by skin thickness, formation of elastic fibers and vascular density. Consistently, in fibroblasts the AF improved cell proliferation and slowed the senescent in vitro. Furthermore, it promoted cellular autophagy to reduce ROS level, which would account for its function in skin renewal. Conclusion The HA with Tri-Hyal could stimulate the production of extracellular matrix components more persistently than traditional HA fillers. In terms of mechanisms, it delayed senescence in dermal fibroblasts through reducing oxidative stress mediated by induction of autophagy.
Collapse
Affiliation(s)
- Rong Chen
- College of Life Sciences, Northwest University, Xi'an, 710069, People's Republic of China
| | - Wenbin Yang
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Jing Sun
- Department of Anesthesiology, Northwest Women's and Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Yuan Liu
- Center of Medical Genetics, Northwest Women's and Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Qing An
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Feijuan Zhang
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| | - Zhuanli Bai
- Department of Plastic and Aesthetic Maxillofacial Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Qi Luan
- Department of Dermatology, Xi'an No.3 Hospital, the Affiliated Hospital of Northwest University, Northwest University, Xi'an, 710069, People's Republic of China
| |
Collapse
|
9
|
Calomeni M, Alfertshofer MG, Frank K, Moellhoff N, Dennison R, Bravo B, Schelke L, Velthuis P, Green JB, Cotofana S. Real-Time Ultrasound Imaging of the Tear Trough: Lessons Learned From Functional Anatomy. Aesthet Surg J 2022; 42:518-526. [PMID: 34610093 DOI: 10.1093/asj/sjab351] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The tear trough is one of the most challenging facial regions for soft-tissue filler injections. A thorough understanding of the underlying facial, muscular, and vascular anatomy is crucial to perform safe and effective tear trough injectable treatments. OBJECTIVES The authors sought to evaluate the location and function of the angular vein in the tear trough in 3 different facial expressions: repose, smiling, and max. orbicularis oculi contraction. METHODS Twenty study participants with a mean age of 48.3 years and mean BMI of 24.5 kg/m2 were investigated via functional ultrasound imaging. The diameter of the angular vein and the velocity and direction of venous blood flow were analyzed in repose, smiling, and during max. orbicularis oculi contraction. RESULTS The angular vein was identified in 100% of the cases to travel inside the orbicularis oculi muscle (intra-muscular course) within the tear trough, whereas the angular artery was not identified in this location. The distance between the angular vein and the inferior orbital rim was (lateral to medial): 4.6 mm, 4.5 mm, 3.9 mm, and 3.8 mm. The caudally directed blood flow was in repose 10.2 cm/s and was 7.3 cm/s at max. orbicularis oculi muscle contraction; however, no blood flow was detectable during smiling. CONCLUSIONS The diameter and the venous blood flow of the angular vein varied between the 3 tested facial expressions. Based on these anatomical findings, the deep injection approach to the tear trough is recommended due to the intramuscular course of the angular vein.
Collapse
Affiliation(s)
| | - Michael G Alfertshofer
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
| | - Konstantin Frank
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
| | - Nicholas Moellhoff
- Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Germany
| | | | | | - Leonie Schelke
- Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | | |
Collapse
|
10
|
Bhojani-Lynch T, Deckers A, Ohanes O, Poupard K, Maffert P. A Prospective, Observational Registry Study to Evaluate Effectiveness and Safety of Hyaluronic Acid-Based Dermal Fillers in Routine Practice: Interim Analysis Results with One Year of Subject Follow-Up. Clin Cosmet Investig Dermatol 2021; 14:1685-1695. [PMID: 34815685 PMCID: PMC8605794 DOI: 10.2147/ccid.s329415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/26/2021] [Indexed: 01/09/2023]
Abstract
Background Monitoring the effectiveness, safety and emerging uses of hyaluronic acid (HA) fillers in their wide range of indications requires a holistic approach. Purpose To propose an observational study design aiming to gather real-world evidence (RWE) and continuously evaluate the performance and safety of marketed devices in routine practice. Materials and Methods A prospective, observational registry was initiated at six European sites. Investigators enrolled any subject receiving at least one injection with a target study device (TEOSYAL Deep Lines [HADL] and/or Global Action [HAGA]). They followed their routine practice regarding injection technique, volume, and subject follow-up. Effectiveness was evaluated at 3 months using the global aesthetic improvement scale (GAIS). Safety was assessed based on common treatment reactions (CTR) and adverse events (AE). Results High quantity of RWE was collected following the initiation of this registry. In the first 158 subjects enrolled, 1220 injections were performed in more than 25 indications, including 679 with the target devices and 271 with devices of the same filler line. The primary objective was achieved, with 93.9% of treatments providing improvement at Month 3 according to the PI and subject. Post-injection CTR were mild to moderate and short-lived, and there was no clinically significant AE. More than 76% of treatments still provided some visible effect at month 12. Conclusion Based on RWE, HADL and HAGL are effective and safe in their respective indications mostly distributed in the midface, perioral region, and lower face. Observational registries are a valuable asset in the context of post-market clinical follow-up.
Collapse
Affiliation(s)
| | - Anne Deckers
- Centre Médical Esthétique Eureka, Dalhem, Belgium
| | - Ohan Ohanes
- Swiss Care Cosmetic & Laser Clinic, London, UK
| | - Kevin Poupard
- Clinical Development Department, Teoxane S.A., Geneva, Switzerland
| | - Pauline Maffert
- Clinical Development Department, Teoxane S.A., Geneva, Switzerland
| |
Collapse
|
11
|
Gorbea E, Kidwai S, Rosenberg J. Nonsurgical Tear Trough Volumization: A Systematic Review of Patient Satisfaction. Aesthet Surg J 2021; 41:NP1053-NP1060. [PMID: 33693530 DOI: 10.1093/asj/sjab116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nonsurgical rejuvenation of the tear trough area via the use of injectable filler material has become a popular procedure in facial rejuvenation. This procedure offers immediate, albeit temporary, results with minimal recovery time. OBJECTIVES The aim of this systematic review was to report on patient satisfaction and complication rates to further guide practitioners. METHODS PubMed, Cochrane, and Scopus libraries were queried for articles containing relevant terms. Articles with more than 5 patients who reported on satisfaction and/or complications from the procedure were included for review. In addition to these variables, we noted other aspects of injection, including filler material, technique, and needle or cannula delivery. Studies that did not otherwise fulfill inclusion criteria for statistical analysis but reported on intravascular injection-related complications were cited. RESULTS Initial query resulted in 1655 studies which were assessed for duplicates and inclusion/exclusion criteria. After screening, 28 articles were included for analysis. In total, 1956 patients were captured who had been injected with 1 of 4 materials: hyaluronic acid (1535), calcium hydroxyapatite (376), autologous fibroblast/keratin gel (35), and collagen-based filler (10). Short- and long-term satisfaction rates were 84.4% and 76.7%, respectively. Minor complications were common (44%). Secondarily, we found the use of cannula for filler injection of this region to be associated with a lower rate of ecchymosis (7% vs 17%, P < 0.05). CONCLUSIONS Filler injection volumization of tear trough deformity is an effective technique for facial rejuvenation associated with high patient satisfaction. Multiple filler materials offer acceptable satisfaction and complication profiles. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Enrique Gorbea
- Department of Otolaryngology, Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah Kidwai
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Joshua Rosenberg
- Department of Otolaryngology, Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
12
|
Alghoul MS, Vaca EE, Bricker JT, Mioton LM. Enhancing the Lateral Orbital "C-Angle" With Calcium Hydroxylapatite: An Anatomic and Clinical Study. Aesthet Surg J 2021; 41:952-966. [PMID: 32719841 DOI: 10.1093/asj/sjaa218] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Deliberate injection of specific facial subunits may improve aesthetic outcomes in facial rejuvenation. We contend that the lateral orbital area (LOA) is a key anatomic subunit in the perception of eye attractiveness, with a C-shaped distribution of fat contributing to the formation of a distinct angle in the lateral orbit. OBJECTIVES The aim of this study was to describe the anatomy of the LOA that constitutes the C-shaped angle and to investigate the safety and cosmetic outcomes of nonsurgical enhancement of that area with calcium hydroxylapatite (CaHA). METHODS Four injected fresh-frozen cadaver heads were dissected. Twenty patients were enrolled in a prospective clinical study. Participants were seen on the day of injection, and at 2 weeks and 3 months postinjection. Two-dimensional and 3D photographs were analyzed to quantify the volumetric changes between pretreatment and postinjection time points. Secondary outcomes included Global Aesthetic Improvement Scale score and subject satisfaction at 3 months. RESULTS Cadaver dissections revealed distinct fat compartments and a zone of adhesion forming the C-shaped area around the lateral orbit. In the clinical study, a mean of 1.88 mL of CaHA was injected into each lateral periorbital region. There was 97% and 76% volume retention at 2 weeks and 3 months, respectively, with 70% of patients being "very satisfied" at 3 months. The average Global Aesthetic Improvement Scale rating at 3 months was 3.95. There were no complications. CONCLUSIONS The LOA is a distinct facial subunit that can be enhanced safely by CaHA injection with good cosmetic outcomes. Focusing on the C-angle can improve periorbital aesthetics. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
| | - Elbert E Vaca
- Northwestern Feinberg School of Medicine Plastic Surgery Program, Chicago, IL
| | | | - Lauren M Mioton
- Northwestern Feinberg School of Medicine Plastic Surgery Program, Chicago, IL
| |
Collapse
|
13
|
Trinh LN, Grond SE, Gupta A. Dermal Fillers for Tear Trough Rejuvenation: A Systematic Review. Facial Plast Surg 2021; 38:228-239. [PMID: 34192769 DOI: 10.1055/s-0041-1731348] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
There is significant variation in treatment parameters when treating the infraorbital region. Thorough knowledge of these pertinent factors, choice of the optimal filling material, and proper understanding of the anatomy of this unforgiving region will contribute to a safe, effective, and natural result. We aim to conduct a systematic review of published literature related to soft tissue fillers of the tear trough and infraorbital region. A search of published literature was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and included PubMed, Embase, and Science Direct databases. The Medical Subject Headings (MeSH) terms used were "tear trough" OR "infraorbital" AND "dermal filler" OR "hyaluronic acid" OR "poly-L-lactic acid" OR "calcium hydroxyapatite" OR "Restylane" OR "Radiesse" OR "Perlane" OR "Juvéderm" OR "Belotero." Different combinations of these key terms were used. The initial search identified 526 articles. Six additional articles were identified through references. Two-hundred twenty-five duplicates were removed. A total of 307 studies were screened by title and abstract and 258 studies were eliminated based on inclusion and exclusion criteria. Forty-nine articles underwent full-text review. The final analysis included 23 articles. Patient satisfaction was high, and duration of effect ranged from 8 to 12 months. Restylane was most commonly used. Injection technique varied, but generally involved placing filler pre-periosteally, deep to orbicularis oculi muscle, anterior to the inferior orbital rim via serial puncture or retrograde linear threading with a 30-gauge needle. Topical anesthetic was most commonly used. Side effects were generally mild and included bruising, edema, blue-gray dyschromia, and contour irregularities. Nonsurgical correction of the tear trough deformity with soft tissue filler is a minimally invasive procedure with excellent patient satisfaction with long-lasting effects. It is essential to have a fundamental understanding of the relevant anatomy and ideal injection technique to provide excellent patient outcomes and prevent serious complications.
Collapse
Affiliation(s)
- Lily N Trinh
- Department of Otolaryngology-Head and Neck Surgery, Tulane University, School of Medicine, New Orleans, Louisiana
| | | | - Amar Gupta
- Department of Otolaryngology-Head and Surgery, St. Elizabeth's Medical Center, Brighton, Massachusetts
| |
Collapse
|
14
|
Nanda S, Bansal S, Lakhani R. Use of Hyaluronic acid fillers in treatment of periorbital melanosis induced by tear trough deformity: Anatomical considerations, patient satisfaction, and management of complications. J Cosmet Dermatol 2021; 20:3181-3189. [PMID: 34028173 DOI: 10.1111/jocd.14251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Periocular melanosis (POM) due to shadow effect of tear trough deformity (TT) does not respond to the conventional treatment modalities. Hyaluronic acid (HA) fillers are a favurable treatment modality. This area is a high risk for injectables due to its unique anatomy. AIMS To find role of HA fillers in treatment POM due to TT deformity with special emphasis on practical anatomy, patient satisfaction rate, and management of complications. A correlation of the grade of TT, age of the patient, and patient satisfaction was done. A follow-up at 1 year was done to assess longevity of results. METHODS Retrospective study of 60 cases of clinically diagnosed POM (120 TT) due to TT deformity was performed. Each patient was injected with 1 ml, cross-linked HA 22.5 mg/ml in under-eye area using 30 G needle or a 25 G cannula. Follow-up was done at 2 weeks, 4 weeks, and 1 year. RESULTS Mean age of patients was 36.4 years. Majority of patients, that is, 31 (52%) were in the age group of 30-40. As per Hirmand's classification, 46.6% (28/60) had grade 2 TT which was most common. We graded results in the form of VAS and 80% patients had VAS > 7. There were no major side effects. CONCLUSION Hyaluronic acid fillers are promising treatment modality without any major side effects. Both needle and cannula can be used effectively. Patient satisfaction is higher in younger patients with low grade of TT and results persisted in all cases for a minimum of 1 year.
Collapse
Affiliation(s)
| | - Shikha Bansal
- Department of Dermatology and STD, VMMC and Safdarjung Hospital, Delhi, India
| | - Ridhima Lakhani
- Department of Dermatology and STD, VMMC and Safdarjung Hospital, Delhi, India
| |
Collapse
|
15
|
The use of periocular fillers in aesthetic medicine. J Plast Reconstr Aesthet Surg 2021; 74:1602-1609. [PMID: 33546985 DOI: 10.1016/j.bjps.2020.12.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/08/2020] [Accepted: 12/20/2020] [Indexed: 11/22/2022]
Abstract
The periocular area is the first to display signs of ageing. Dermal fillers are an increasingly popular, minimally invasive method for facial rejuvenation. The eye is anatomically delicate and complex. Therefore, special consideration must be taken if dermal fillers are employed. This article examines the literature to assess the efficacy and safety of dermal fillers around the eye as well as the management of complications secondary to dermal filler use, such as oedema, granuloma formation, filler migration, xanthelasma, skin necrosis and visual loss. Hyaluronic acid (HA) is the most popular and commonly employed dermal filler for periocular use. It is effective, with good observer improvement and patient satisfaction (p<0.0001). Ninety percent of adverse events are mild in nature and self-resolve within 1 month. Malar oedema is a delayed complication unique to the periocular area, occurring in 11% of patients. This can be managed with use of hyaluronidase if a HA filler has been employed. Other complications, such as granuloma formation, filler migration and xanthelasma, have also been reported with variable management outcomes. Vascular adverse events include skin necrosis and visual loss. No Level 1 evidence exists for the management of visual loss. Two cases of visual restoration have been identified in the literature; however, this is rare.
Collapse
|
16
|
Kounidas G, Kastora S, Rajpara S. Decoding infraorbital dark circles with lasers and fillers. J DERMATOL TREAT 2020; 33:1563-1567. [PMID: 33272039 DOI: 10.1080/09546634.2020.1855297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The degree and severity of dark circles varies according to the skin type, age, and lifestyle. OBJECTIVES To evaluate different non-surgical treatment options for dark circles. METHODS In a private practice setting in the UK and India, 34 patients with dark circles with different Fitzpatrick skin types were treated with fillers (Group 1), lasers (Group 2), and fillers and lasers combined (Group 3). Pre and post treatment photos were taken and subjective and objective outcomes in appearance were reported. RESULTS All treatment options were effective in all three groups with minimal side effects reported. No statistically significant difference was found between the three treatment groups. Patients who had tear troughs and/or hollow eyes responded well to fillers, patients with loose and wrinkled skin to CO2 laser, patients with tear troughs and hyperpigmentation to fillers, Q switched Nd:YAG and topical agents and patients with tear troughs and veins to fillers and long pulsed Nd:YAG lasers. Most patients (82%) rated the improvement in their appearance as excellent. CONCLUSIONS All 3 treatment modalities were effective in the reduction of periorbital dark circles depending on underlying cause. Non-surgical treatments are capable of correcting and improving dark circles with minimum complications and downtime.
Collapse
Affiliation(s)
- Georgios Kounidas
- Department of Medical Sciences and Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
| | - Stavroula Kastora
- Department of Medical Sciences and Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
| | - Sanjay Rajpara
- Department of Medical Sciences and Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom.,Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| |
Collapse
|
17
|
Anido J, Fernández JM, Genol I, Ribé N, Pérez Sevilla G. Recommendations for the treatment of tear trough deformity with cross-linked hyaluronic acid filler. J Cosmet Dermatol 2020; 20:6-17. [PMID: 32844581 PMCID: PMC7818415 DOI: 10.1111/jocd.13475] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
Abstract
Background Recent years have seen a growing interest in the appearance of the eyes among the concerns expressed by patients in cosmetic clinics. This has led to an increase in the frequency of diagnosis of tear trough deformity, and, as a result, the number of treatments performed by specialized professionals has also risen. Hyaluronic acid filler injection is a rapid, nonsurgical technique that gives good long‐lasting, but not permanent, results. However, to achieve optimal results, the attending physician must have good anatomical knowledge of the area and involvement of the structures in the tear trough, carry out proper clinical assessment of the patient, and use an appropriate injection technique with the right product. Aims To support good practice among the professionals who carry out these procedures, this interdisciplinary consensus document describes the relevant issues and recommendations, in order to improve safety standards and to help successfully resolve this aesthetic problem.
Collapse
Affiliation(s)
- Javier Anido
- Medicina Estética, Clínica Anido Health & Beauty, Madrid, Spain
| | | | - Ignacio Genol
- Oftalmología y Cirugía Oculoplástica, Clínica Dr. Ignacio Genol, Madrid, Spain
| | - Natalia Ribé
- Institut Dra Natalia Ribé, Andrología y Medicina Estética, Barcelona, Spain
| | - Gema Pérez Sevilla
- Hospital La Milagrosa, Unidad de Medicina y Cirugía Estética Facial Avanzada, Madrid, Spain
| |
Collapse
|
18
|
A Prospective Study on Safety, Complications and Satisfaction Analysis for Tear Trough Rejuvenation Using Hyaluronic Acid Dermal Fillers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2753. [PMID: 32440421 PMCID: PMC7209844 DOI: 10.1097/gox.0000000000002753] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 02/03/2020] [Indexed: 11/26/2022]
Abstract
Background: Tear trough (TT) treatment with hyaluronic acid soft tissue fillers is an increasingly popular aesthetic procedure. The traditional needle technique is cited many times in the literature with no studies looking at the results, complications and satisfaction rate with the use of the cannula device instead. The aims of this study are to describe the experience of 4 aesthetic doctors in the treatment of TT deformity and assess complications and side effects, overall satisfaction and improvement. Methods: Twenty-four patients were included (48 TTs) that fulfilled the inclusion and exclusion criteria and they were assessed over a 4-week period, looking at the complications, side effects, satisfaction rate, and others with the cannula technique for the medial TT. Results: Twenty-two women and 2 men each had the medial TT filler supra-periosteally using a cannula device. They were all reviewed at the 2-week stage +/− the 4-week stage. 100% of patients noted an overall improvement to the TTs and 75% were satisfied with their results with the other 25% requiring further filler to be satisfied. There were no major complications and only a small number of minor side effects like mild bruising and swelling that lasted up to 4 weeks. Conclusions: TT treatment, if performed using a cannula with a maximum of 1ml used in one sitting between both eyes, according to this study, is a safe treatment with a very low pain rating and with no major complications and high patient satisfaction.
Collapse
|
19
|
Yang Y, Sheng H, Gu Q, Su L, Tong H, Chen J, Qi X. Death Caused by Vaginal Injection of Hyaluronic Acid and Collagen: A Case Report. Aesthet Surg J 2020; 40:NP263-NP268. [PMID: 31606736 DOI: 10.1093/asj/sjz275] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
With the expanding utilization of hyaluronic acid (HA) and collagen as cosmetic fillers in plastic and reconstructive surgery, complications due to their excessive use and/or irregular procedures warrant great caution. Recently, a fatal case occurred caused by a poorly regulated procedure of vaginal injection of HA and collagen. A 33-year-old female was admitted to the emergency department 3 hours after the operation with a chief complaint of dyspnea, which initiated 5 to 10 minutes after the operation. Her blood pressure remained low while dopamine pressor and fluid replacement were used. Computed tomography of the chest showed local exudation in the lower lobe of the left lung, enlargement of right atrium and ventricle, and uneven development of the bilateral inferior lobar artery with filling defects. Pulmonary computed tomography angiography and three-dimensional reconstruction showed continuous interruption of pulmonary artery branches of the posterior basal segment of the right lower lobe. Unfortunately, the clinical symptoms caused by vaginal injection aggravated rapidly and could not be effectively controlled. The patient died 9 hours after injection. Pulmonary complications after injection of cosmetic fillers are scarcely reported. Thus far, only 2 cases of HA-related pulmonary complications after vaginal injection have been described. The present case emphasizes that surgeons and other healthcare providers must be aware of the risk of serious pulmonary complications and even death associated with these 2 widely utilized injectable fillers. Level of Evidence: 5.
Collapse
Affiliation(s)
- Yang Yang
- Guangzhou University of Traditional Chinese Medicine, Guangzhou city, Guangdong province, China
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Hengwei Sheng
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Qinmei Gu
- Guangzhou University of Traditional Chinese Medicine, Guangzhou city, Guangdong province, China
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Lei Su
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Huasheng Tong
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Jianwu Chen
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
| | - Xiangdong Qi
- Department of Plastic Surgery, General Hospital of Southern Theatre Command, Guangzhou city, Guangdong province, China
- College of Clinical Medicine, Southern Medical University, Guangzhou city, Guangdong province, China
| |
Collapse
|
20
|
Matecka M, Lelonkiewicz M, Pieczyńska A, Pawlaczyk M. Subjective Evaluation of the Results of Injectable Hyaluronic Acid Fillers for the Face. Clin Interv Aging 2020; 15:39-45. [PMID: 32021131 PMCID: PMC6968800 DOI: 10.2147/cia.s233405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/11/2019] [Indexed: 11/23/2022] Open
Abstract
Background Skin ageing is a physiological process, progressive and irreversible. Hyaluronic acid injection treatments are used to correct the signs of skin ageing. Material and Methods Hyaluronic acid was implanted in the area of the cheek and the forehead aesthetic units in 57 women, aged 35-55 years. Apart from the clinical observation, self-assessment of the therapeutic results was conducted. The "My skin" questionnaire was used for subjective evaluation of the treatment results. Results Mean wrinkle score in the pre-menopausal group changed after the treatment, from 3.2±0.6 to 1.1±0.3 and from 3.2±0.6 to 0.8±0.6 for the forehead and the cheek esthetic units, respectively. In the post-menopausal group, the score decreased from 3.8±0.4 to 1.7± 0.7 and from 3.2±0.617 to 0.8± 0.6 for the forehead and the cheek esthetic units, respectively. The changes were age-dependent. Improved appearance of the facial skin - higher satisfaction with skin tone and scent - was reported after hyaluronic acid injections. Higher subjective perception of improvement corresponded to older age, irrespectively of the menopausal status. Correlations between age and the effect of the treatment on maintaining proper skin hydration as well as between improved appearance of the forehead area and feelings of autonomy and well-being were found. Conclusion Hyaluronic acid injections significantly improved the subjective perception and overall assessment of the scent and appearance of the facial skin.
Collapse
Affiliation(s)
- Monika Matecka
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Anna Pieczyńska
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
21
|
Hussain SN, Mangal S, Goodman GJ. The Tick technique: A method to simplify and quantify treatment of the tear trough region. J Cosmet Dermatol 2019; 18:1642-1647. [DOI: 10.1111/jocd.13169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/15/2019] [Accepted: 05/15/2019] [Indexed: 11/27/2022]
Affiliation(s)
| | - Sonia Mangal
- Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Greg J. Goodman
- Department of Primary Care Monash University Clayton Vic. Australia
- Skin and Cancer Foundation Inc Clayton Vic. Australia
| |
Collapse
|
22
|
|
23
|
Bukhari SNA, Roswandi NL, Waqas M, Habib H, Hussain F, Khan S, Sohail M, Ramli NA, Thu HE, Hussain Z. Hyaluronic acid, a promising skin rejuvenating biomedicine: A review of recent updates and pre-clinical and clinical investigations on cosmetic and nutricosmetic effects. Int J Biol Macromol 2018; 120:1682-1695. [PMID: 30287361 DOI: 10.1016/j.ijbiomac.2018.09.188] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 09/04/2018] [Accepted: 09/28/2018] [Indexed: 10/28/2022]
Abstract
Hyaluronic acid (HA) plays multifaceted role in regulating the various biological processes such as skin repairmen, diagnosis of cancer, wound healing, tissue regeneration, anti-inflammatory, and immunomodulation. Owing to its remarkable biomedical and tissue regeneration potential, HA has been numerously employed as one of the imperative components of the cosmetic and nutricosmetic products. The present review aims to summarize and critically appraise recent developments and clinical investigations on cosmetic and nutricosmetic efficacy of HA for skin rejuvenation. A thorough analysis of the literature revealed that HA based formulations (i.e., gels, creams, intra-dermal filler injections, dermal fillers, facial fillers, autologous fat gels, lotion, serum, and implants, etc.) exhibit remarkable anti-wrinkle, anti-nasolabial fold, anti-aging, space-filling, and face rejuvenating properties. This has been achieved via soft tissue augmentation, improved skin hydration, collagen and elastin stimulation, and face volume restoration. HA, alone or in combination with lidocaine and other co-agents, showed promising efficacy in skin tightness and elasticity, face rejuvenation, improving aesthetic scores, reducing the wrinkle scars, longevity, and tear trough rejuvenation. Our critical analysis evidenced that application/administration of HA exhibits outstanding nutricosmetic efficacy and thus is warranted to be used as a prime component of cosmetic products.
Collapse
Affiliation(s)
- Syed Nasir Abbas Bukhari
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Aljouf 2014, Saudi Arabia
| | - Nur Liyana Roswandi
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Selangor, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Muhammad Waqas
- Johar Institute of Professional Studies Lahore, Nabi Bux, Main Ferozpur Road, Punjab, Pakistan
| | - Haroon Habib
- Johar Institute of Professional Studies Lahore, Nabi Bux, Main Ferozpur Road, Punjab, Pakistan
| | - Fahad Hussain
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Raiwind Road, 55150 Lahore, Pakistan
| | - Shahzeb Khan
- Department of Pharmacy, University of Malakand, Dir Lower, Chakdara, KPK, Pakistan
| | - Muhammad Sohail
- Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad 22060, Pakistan
| | - Nor Amlizan Ramli
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Selangor, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Hnin Ei Thu
- Department of Pharmacology and Dental Therapeutics, Faculty of Dentistry, Lincoln University College, Jalan Stadium, SS 7/15, Kelana Jaya, 47301 Petaling Jaya, Selangor, Malaysia
| | - Zahid Hussain
- Department of Pharmaceutics, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Selangor, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia.
| |
Collapse
|
24
|
Hall MB, Roy S, Buckingham ED. Novel Use of a Volumizing Hyaluronic Acid Filler for Treatment of Infraorbital Hollows. JAMA FACIAL PLAST SU 2018; 20:367-372. [PMID: 29621374 PMCID: PMC6233621 DOI: 10.1001/jamafacial.2018.0230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/15/2018] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Hyaluronic acid filler can be safely used as a soft-tissue filler for correction of infraorbital hollowing. It has a high overall patient satisfaction profile among patients. OBJECTIVE To report safety and patient satisfaction outcomes of Juvéderm Voluma XC for correction of infraorbital hollows. DESIGN, SETTING, AND PATIENTS This was a retrospective observational study performed at a private ambulatory facial plastic and reconstructive surgery practice. Participants were all patients 21 to 85 years old who presented to our practice and underwent Juvéderm Voluma XC treatment for correction of infraorbital hollows as a singular intervention from February 2016 to March 2017. INTERVENTIONS Injection of Juvéderm Voluma XC to the tear trough, nasojugal fold, and/or palpebromalar groove. MAIN OUTCOMES AND MEASURES Primary outcome measures include the number of recorded short- and long-term adverse events, need for additional treatment, and patient questionnaire FACE-Q scores. RESULTS A total of 202 eyes were treated in 101 patients with a mean follow-up of 12 months. Patients were principally female (90 [89%]) with an average age of 54 years (range, 21-85 years). Most patients (99) had Fitzpatrick grade 1 to 4 skin type (98%) and had an infraorbital hollows score of 2 to 4 (89 [88%]). The average initial treatment volume was 1 mL with 18 patients (18%) requiring additional treatment within 3 months. The average time until additional treatment was 35.7 days. Adverse effects include bruising (in 10 [10%], contour irregularities (2 [2%]), swelling (3 [3%]), and Tyndall effect (1 [1%]). Hyaluronidase was required in 3 patients (3%). Forty-one patients completed the FACE-Q Satisfaction With Eyes survey, and 42 patients completed the FACE-Q Satisfaction With Decision survey (41% and 42%). Overall mean (SD) patient satisfaction (based on FACE-Q scores) was 71.1% (27.3) and 65.6% (31.3), respectively. CONCLUSIONS AND RELEVANCE Juvéderm Voluma XC has a high patient satisfaction profile and an acceptable safety profile for the correction of infraorbital hollowing. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
| | - Sudeep Roy
- Buckingham Center for Facial Plastic Surgery, Austin, Texas
| | | |
Collapse
|
25
|
Guduk SS. An Unusual Delayed Type Reaction Following Periorbital Filler Injection With Hyaluronic Acid. Aesthet Surg J 2018; 38:NP109-NP113. [PMID: 29420683 DOI: 10.1093/asj/sjy035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
LEVEL OF EVIDENCE 5
Collapse
|