Collagen injections for aging skin lines (wrinkles)

New Regenerative and Anti-Aging Medicine Approach Based on Single-Stranded Alpha-1 Collagen for Neo-Collagenesis Induction: Clinical and Instrumental Experience of a New Injective Polycomponent Formulation for Dermal Regeneration

This study explores the efficacy of a novel polycomponent formulation (KARISMA Rh Collagen® FACE, Taumedika Srl, Rome, Italy), containing 200 mg/mL of non-crosslinked high-molecular-weight hyaluronic acid (HMW-HA), 200 μg/mL of a human recombinant polypeptide of collagen-1 alpha chain, and 40 mg/mL of carboxymethyl cellulose (CMC) as a regenerative medicine for skin regeneration and rejuvenation. This formulation combines non-crosslinked high-molecular-weight hyaluronic acid, human recombinant polypeptide of collagen-1 alpha chain, and carboxymethyl cellulose to stimulate collagen type I production and enhance skin hydration. This study involved 100 subjects with varying skin conditions, divided into three groups based on skin aging, smoking history, and facial scarring, to evaluate the product's effectiveness in skin regeneration and aesthetic improvement. The methodology included two injections of Karisma (2 mL for each injection) one month apart, with evaluations conducted using FACE-Q questionnaires, the SGAIS Questionnaire, and Antera 3D skin scanner measurements at baseline, 30 days, and 60 days post-treatment. The results demonstrated a significant reduction in skin roughness and an improvement in skin quality across all the groups, with no correlation between the outcomes and the patient's age. The subjective assessments also indicated high satisfaction with the treatment's aesthetic results. The analyzed data allow us to conclude that the single-stranded collagen with hyaluronic acid and carboxymethyl-cellulose formulation is able to stimulate the skin's regenerative response, yielding significant results both in vitro and, through our study, also in vivo. This new polycomponent formulation effectively stimulates skin regeneration, improving skin quality and texture, with significant aesthetic benefits perceived by patients, and a low incidence of adverse events, marking a promising advancement in regenerative medicine.

Self-assembled adipose-derived mesenchymal stem cells as an extracellular matrix component- and growth factor-enriched filler

The clinical application of mesenchymal stem cells (MSCs) is attracting attention due to their excellent safety, convenient acquisition, multipotency, and trophic activity. The clinical effectiveness of transplanted MSCs is well-known in regenerative and immunomodulatory medicine, but there is a demand for their improved viability and regenerative function after transplantation. In this study, we isolated MSCs from adipose tissue from three human donors and generated uniformly sized MSC spheroids (∼100 µm in diameter) called microblocks (MiBs) for dermal reconstitution. The viability and MSC marker expression of MSCs in MiBs were similar to those of monolayer MSCs. Compared with monolayer MSCs, MiBs produced more extracellular matrix (ECM) components, including type I collagen, fibronectin, and hyaluronic acid, and growth factors such as vascular endothelial growth factor and hepatocyte growth factor. Subcutaneously injected MiBs showed skin volume retaining capacity in mice. These results indicate that MiBs could be applied as regenerative medicine for skin conditions such as atrophic scar by having high ECM and bioactive factor expression.

Long-term efficacy of a novel ribose-cross-linked collagen dermal filler: a histologic and histomorphometric study in an animal model

BACKGROUND

Degradation and loss of the three-dimensional shape are the major causes of limited functional longevity of dermal fillers made of natural polymers as collagen and hyaluronic acid.

OBJECTIVE

This study assessed the functional longevity of a new ribose-cross-linked collagen filler during 24 months in an animal model.

METHODS

Ribose-cross-linked collagen (Evolence, Colbar Life Sciences Ltd), glutaraldehyde-cross-linked collagen (Zyplast, Inamed Inc.), and non-cross-linked collagen (Zyderm, Inamed Inc.) were injected in the rabbit ear dermis. Biopsies obtained at 1, 6, 12, and 24 months were histomorphometrically assessed for shape preservation and cell repopulation.

RESULT

The three-dimensional shape of Evolence remained stable during 24 months. Zyderm and Zyplast lost their three-dimensional shape after 6 months. Although the cell density in Evolence remained stable over time, that in Zyplast and Zyderm decreased significantly at 12 and 24 months.

CONCLUSION

Ribose-cross-linked collagen is endowed with a higher functional longevity as assessed in an animal model when compared with the most used collagen-based dermal fillers.

A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds

BACKGROUND

Bovine collagen is extensively used for facial soft tissue augmentation but provides only temporary correction and can cause hypersensitivity reactions. Hyaluronic acid derivatives potentially offer improved longevity of correction and a reduced risk of immunogenicity and hypersensitivity.

OBJECTIVE

To compare the efficacy and safety of nonanimal stabilized hyaluronic acid gel (Restylane; Q-Med, Uppsala, Sweden) with that of bovine collagen (Zyplast) for treatment of nasolabial folds.

METHODS

One hundred thirty-eight patients with prominent nasolabial folds were randomized to treatment with hyaluronic acid gel and bovine collagen on contralateral sides of the face. Treatments were repeated at 2-week intervals, as required, to achieve "optimal cosmetic result" (baseline). Outcomes were evaluated by a blinded investigator at 2, 4, and 6 months after baseline.

RESULTS

Less injection volume was required for "optimal cosmetic result" with hyaluronic acid gel than with bovine collagen, and patients and investigators judged hyaluronic acid gel to be more effective in maintaining cosmetic correction. The investigator-based Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale assessments at 6 months after baseline indicated that hyaluronic acid gel was superior in 56.9% and 62.0% of patients, respectively, whereas bovine collagen was superior in 9.5% and 8.0% of patients, respectively. The frequency, intensity, and duration of local injection-site reactions were similar for the two products.

CONCLUSION

Nonanimal stabilized hyaluronic acid provides a more durable aesthetic improvement than bovine collagen and is well tolerated.

Clinical use of Zyplast in correction of age- and disease-related contour deficiencies of the face

The authors present their experience with the use of Zyplast (glutaraldehyde crosslinked collagen) for the treatment of skin creases in the aging face, lip augmentation, scars, and facial atrophy. One hundred female patients were studied over a nine-month period. The results were found to be superior in some aspects compared with Zyderm II collagen, but there is loss of correction after six months and repeated "top-up" injections are needed every four to six months to maintain a satisfactory cosmetic correction. Zyplast collagen has not reduced the number of patient visits nor the cost of treatment.

Long-term safety and efficacy with Fibrel in the treatment of cutaneous scars--results of a multicenter study. Multicenter study group

Three hundred patients were treated with Fibrel (Serono Laboratories, Randolph, MA) for the correction of cutaneous scars. Fibrel treatment was restricted to four scars with one or two treatments following a negative skin test. The scar corrections were evaluated by the physician, the patient, and also via an objective photogrammetric method. At the end of 1 year, the percentages of scars with moderate, marked, or complete correction were 65.0%, 63.3%, and 85.8% according to physician, patient, and photogrammetric evaluations, respectively. A cohort of 111 patients from the 1-year study were followed for up to 2 years postimplantation to evaluate safety and efficacy. These patients had similar demographic and scar characteristics as the total patient population in the initial study. The efficacy evaluation at the end of 24 months indicated that successful correction was maintained in 64.4%, 58.9%, and 78.9% of scars for physician, patient, and photogrammetric evaluations, respectively. There were no severe hypersensitivity reactions following treatment with Fibrel. The data from these patients demonstrate that one or two Fibrel treatments are effective in maintaining the correction of depressed cutaneous scars for up to 2 years with negligible adverse sequelae.

Injectable collagen implant: histopathologic identification and longevity of correction

This prospective study reports the results of the longevity of the correction achieved in 312 patients receiving injectable collagen implant and the histopathologic identification of the implant in the six who experienced reactions at the treatment sites. In reporting results in cosmetic patients, certain ones can be considered objective or factual, and other must be judged subjective. This study reports both kinds of results and proposes a new theory to explain the duration of the improvement.