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Dermal Fillers (dermal + filler)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

A Randomized Trial to Determine the Influence of Laser Therapy, Monopolar Radiofrequency Treatment, and Intense Pulsed Light Therapy Administered Immediately after Hyaluronic Acid Gel Implantation

DERMATOLOGIC SURGERY, Issue 5 2007
MITCHEL P. GOLDMAN MD
BACKGROUND Hyaluronic acid-based dermal fillers, such as hyaluronic acid gel (Restylane, Q-Medical AB, Uppsala, Sweden), are widely used for tissue augmentation of the nasolabial folds. Additional dermatologic treatments using infrared light, radiofrequency (RF), and intense pulsed light (IPL) are also important tools for facial rejuvenation. This study was designed to evaluate whether these therapies could be safely administered immediately after hyaluronic acid gel treatment without compromising the effect of the dermal filler. OBJECTIVE The objective of this study was to confirm or refute any possible subtractive effects of augmentation of the nasolabial folds when followed by 1,320-nm Nd:YAG laser, 1,450-nm diode laser, monopolar RF, and/or IPL treatments. METHODS Thirty-six patients with prominent nasolabial folds were treated with hyaluronic acid gel implantation on one side of the face and hyaluronic acid gel followed by one of the nonablative laser/RF/IPL therapies on the contralateral side of the face. RESULTS There were no statistically significant differences between wrinkle severity or global aesthetic scores for hyaluronic acid gel implantation alone and hyaluronic acid gel with laser/RF/IPL treatment at any time point. In a small sample, histologic changes were not apparent after laser/RF/IPL treatment. CONCLUSIONS Based on this small pilot study, laser, RF, and IPL treatments can safely be administered immediately after hyaluronic acid gel implantation without reduction in overall clinical effect. [source]

Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV-positive patients: 3-year follow-up study

HIV MEDICINE, Issue 3 2010
L Skeie
Objectives Facial lipoatrophy can be a stigmatizing side effect of antiretroviral (AVR) treatment for HIV-infected patients. We sought to evaluate the long-term efficacy and safety of a new formulation of hyaluronic acid that can be injected in larger amounts and into deeper skin layers during 3 years of follow-up. Methods Twenty patients received injections of Restylane SubQÔ. Refill treatment was offered at 12 and 24 months. Treatment effects were evaluated using ultrasound, the Global Aesthetic Improvement Scale, visual analogue scale (VAS) and the Rosenberg self-esteem scale. Results Seventeen patients remained at 36 months. Mean (± standard deviation) total cutaneous thickness increased from 6 ± 1 mm at baseline to 12 ± 1 mm (P<0.001) at 36 months. Response rate (total cutaneous thickness >10 mm) was 70%. Fifteen patients classified their facial appearance as very much or moderately improved. VAS increased from 39 ± 25 to 70 ± 20 (P<0.05) and higher self-esteem scores were reported. Local swelling and tenderness after treatment was common. Persistent papules found in several patients after treatment were removed effectively with hyaluronidase injections. Three patients, treated only at baseline, still had higher total cutaneous thickness scores at 36 months. Conclusions Our results indicate that a large particle hyaluronic acid formulation is a durable and well-tolerated dermal filler for treating HIV-positive patients with facial lipoatrophy. [source]

Hyaluronic acid treatment of facial fat atrophy in HIV-positive patients

HIV MEDICINE, Issue 8 2007
H Bugge
Objectives Facial lipoatrophy can be devastating for HIV-infected patients, with negative effects on self-esteem. In this study, we treated facial fat atrophy in the nasogenian area with hyaluronic acid (Restylane SubQ; Q-Med AB, Uppsala, Sweden). Methods Twenty patients were included in the study. Treatment effects were evaluated at baseline, and at weeks 6, 24 and 52 using ultrasound, the Global Aesthetic Improvement Scale, the Visual Analogue Scale and the Rosenberg Self-Esteem Scale. Results Mean (±standard deviation) total cutaneous thickness increased from 6±1 mm at baseline to 15±3 mm at week 6 (P<0.001), and declined to 10±2 mm at week 52 (P<0.001 vs baseline). The response rate (total cutaneous thickness >10 mm) was 100% at week 6, 85% at week 24 and 60% at week 52. At week 6, all of the patients classified their facial appearance as very much improved or moderately improved. They also reported increased satisfaction with their facial appearance and had higher self-esteem scores. At week 52, 15 of 19 patients still classified their facial appearance as very much improved or moderately improved, although the mean total cutaneous thickness had gradually declined. Conclusions Our results indicate that Restylane SubQ is a useful and well-tolerated dermal filler for treating HIV-positive patients with facial lipoatrophy. [source]

European evaluation of a new hyaluronic acid filler incorporating lidocaine

JOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2008
Gregor Wahl MD
Summary Background, A new dermal filler has been developed with preincorporated lidocaine for the treatment of moderate/severe wrinkles. Aims, Injector and patient evaluation of comfort and aesthetic results obtained with a new hyaluronic acid filler incorporating lidocaine (HAL) following treatment of nasolabial folds. Patients/Methods, Three thousand five hundred and sixty-six patients were recruited by 485 injectors across 16 countries. All patients had previously received facial fillers but now required further treatment. All patients received the new hyaluronic acid filler incorporating lidocaine. Results, Injector assessment of HAL was that it was very easy to inject in > 75% of patients, and postinjection sculpting/massaging was very easy in most patients (> 70%). Both injectors and patients reported low patient pain levels, with patients experiencing less pain during all stages of the HAL injection procedure compared to previous dermal fillers. Over 95% of injectors rated the aesthetic effect of HAL as "excellent" or "good," with 99.1% stating they would recommend treatment to a colleague and 99.4% recommending treatment to other patients. More than 90% of patients were happy with the treatment, and 99% would recommend HAL to friends. Conclusions, The new hyaluronic acid filler incorporating lidocaine provides a more comfortable injection experience and improved aesthetic result for most patients compared with other dermal fillers used previously. [source]

Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2008
J Alijotas-Reig
Abstract Introduction Implantation of dermal filler for cosmetic purposes is becoming increasingly common worldwide. It is thought that hyaluronic acid (HA) alone or combined with acrylic hydrogels (HA-AH) does not have severe nor persistent side-effects. However, recent evidence may show that major, local and/or systemic, immediate or delayed adverse effects may appear in relation with its use. Objective To evaluate the clinical complaints, laboratory data, treatment and follow-up of patients with delayed adverse effects related to HA and HA-AH implant fillers. Design Prospective, case-series study of patients filled with HA and HA-AH compounds. Setting The study has been done in a tertiary, teaching university hospital. Patients We report on a series of 25 patients, 15 of them in prospective manner, with severe, delayed side-effects related to HA-AH. Inclusion criteria have been drawn up. Patients with immediate side-effects were excluded. Patients were submitted to a clinical follow-up, battery of blood tests and thorax X-ray films. Besides, a review of the literature was made. We undertook a computed-assisted (MEDLINE), National Library of Medicine, Bethesda, MD, USA, search of the literature from 1996 up to December 2005. Main outcome Clinical evaluation of granulomas, skin manifestations and other local and systemic immune-mediated disorders possibly related to HA and HA-AH fillers or their cumulative interaction with previously administered fillers. Results Of 25 cases, 16 were filled with HA alone and 9 with a HA-AH compounds. Of 15 cases analysed and with long-term follow-up, 10 were filled with HA alone, and the remaining five were filled with a HA-AH. Time latency average up to beginning of symptoms was 13.7 months. Three of these 15 cases had been filled before with silicone and another one with Artecoll. Tender nodules were seen in 14 patients. Systemic manifestations appeared in three cases. Laboratory abnormalities were noted in all studied cases. After 16-month average follow-up, seven patients seem to be cured, and six have recurrent bouts. Two cases were lost during follow-up. Conclusion Although in some cases, these clinical complications might have been associated with previous fillers or with other unknown foreign bodies, we feel that, although infrequently, delayed and recurrent chronic inflammatory and granulomatous reactions may complicate HA and HA-AH implant fillers. [source]

In Vitro Resistance to Degradation of Hyaluronic Acid Dermal Fillers by Ovine Testicular Hyaluronidase

DERMATOLOGIC SURGERY, Issue 2010
DEREK JONES MD
BACKGROUND Although adverse events are uncommon with hyaluronic acid (HA) fillers, the use of hyaluronidase permits the reversal of treatment complications or overcorrection. OBJECTIVE This study sought to determine an in vitro dose-response relationship between ovine testicular hyaluronidase (OTH) and three HA dermal fillers (24-mg/mL smooth gel, 20-mg/mL particulate gel, and 5.5-mg/mL particulate gel with 0.3% lidocaine). METHODS AND MATERIALS The dose response of each was measured after incubation for 30 minutes in concentrations ranging between 5 and 40 U of OTH. Timed responses for the 24-mg/mL and 20-mg/mL HA fillers were obtained after incubation with 20 U of OTH for 15 to 120 minutes. RESULTS After all dose responses and timed-interval tests, the 24-mg/mL HA smooth gel filler exhibited more resistance against in vitro enzymatic degradation to OTH than the 20- and 5.5-mg/mL HA particulate gels. CONCLUSION This resistance to degradation in vitro may be attributed to the higher HA content of the 24-mg/mL HA smooth gel, the degree of crosslinking, and the cohesive property of the gel filler. This study was funded by a grant from Allergan, Inc., Santa Barbara, CA. Derek Jones, MD, is a consultant, investigator, advisory board member, and speaker for Allergan, Inc. He received no compensation for this study. Drs. Tezel and Borrell are employed by Allergan, Inc., Santa Barbara, CA. Editorial assistance was provided by Health Learning Systems, a part of CommonHealth, Parsippany, NJ. [source]

A Randomized Trial to Determine the Influence of Laser Therapy, Monopolar Radiofrequency Treatment, and Intense Pulsed Light Therapy Administered Immediately after Hyaluronic Acid Gel Implantation

Injectable Hyaluronic Acid Implant for Malar and Mental Enhancement

DERMATOLOGIC SURGERY, Issue 7 2006
FRCP, NICHOLAS J. LOWE MD
BACKGROUND The use of a thicker injectable implant version of one of the hyaluronic acid dermal fillers (Restylane SubQ, Q-Med, Uppsala, Sweden) is described. OBJECTIVE A group of treated patients has been studied for more than 1 year. Restylane SubQ was injected to the submuscular plane of the upper cheeks and chin to observe efficacy of augmentation and side effect profile, and further observations were made of the duration of benefit. METHODS Patient details,72 patients were treated, 68 for upper cheek augmentation, 2 for chin augmentation, and 2 for both areas. Four patients received second injections 8 weeks after the first to increase augmentation. RESULTS Patients all showed a persistence of benefit during the posttreatment observation period of up to 64 weeks. Four patients had minor side effects that resolved with local treatment and time. Four patients had second injections to complete augmentation without complications. CONCLUSIONS Restylane SubQ is a useful injectable agent to augment and lift upper cheeks and recontour chins. Further efficacy studies seem justified. [source]

Injection Necrosis of the Glabella: Protocol for Prevention and Treatment After Use of Dermal Fillers

DERMATOLOGIC SURGERY, Issue 2 2006
ADRIENNE S. GLAICH MD
BACKGROUND Injection of filler materials into the dermis is well tolerated with few mild and transient side effects. Injection necrosis is a rare but clinically important potential complication caused by interruption of the vascular supply to the area by compression, injury, and/or obstruction of the vessel(s). The glabella is a particular danger zone for injection necrosis regardless of the type of filler used. OBJECTIVE We recommend a protocol that may be used to help prevent and treat injection necrosis of the glabella after injection with dermal fillers. CONCLUSION Injection necrosis in the glabellar region may be prevented by a knowledge of the local anatomy and an understanding of its pathophysiology and treated by a suggested protocol. [source]

Aging well , the role of minimally invasive aesthetic dermatological procedures in women over 65

JOURNAL OF COSMETIC DERMATOLOGY, Issue 1 2010
Uwe Wollina MD
Summary Background, The western world is getting older. Aging well has become the new target of preventative medicine. Aesthetic dermatology can contribute to this quest. Females over 65 represent an important and growing group of consumers of cosmetic procedures. In this group, there is a paucity of scientific evaluation of aesthetic procedures. Objective, To review the use of minimally invasive procedures for facial rejuvenation in women over 65. Methods, Drawing from both the literature and personal experience, the opportunities, modifications, and limitations of minimally invasive techniques for facial rejuvenation in older women are considered. Results, In this older age group, dermal fillers, chemical and laser peels, and nonablative photorejuvenation remain useful and can each be used as stand-alone treatments. In this age group, botulinum toxin (BTX) injections are more often used in combination with other procedures. Conclusions, With respect to aesthetic procedures, women over 65 are different from younger women. More scientific investigation is necessary to better meet needs of this growing part of the population. Available data suggest that aesthetic dermatology can make a major contribution to the complex matter of aging well. [source]

The science and art of hyaluronic acid dermal filler use in esthetic applications

JOURNAL OF COSMETIC DERMATOLOGY, Issue 4 2009
Michael Gold MD
Summary Background, The number of dermal fillers has expanded dramatically; clinicians can benefit from practical information on their optimal use. Aims, To review key determinants of dermal filler performance, to discuss technical considerations, and to illustrate these factors based on the author's clinical experience. Methods, Current literature pertaining to the physicochemical properties of hyaluronic acid (HA) dermal fillers and implications for clinical use was reviewed. The author provides clinical guidelines for optimizing outcomes, illustrated with three case examples. Results, Hyaluronic acids are nonimmunogenic, versatile, reversible, and have excellent benefit,risk profiles, making them near-ideal filling agents. They differ in their manufacturing processes, viscosity, hardness, cohesivity, ease of injection, and ideal uses. Patient counseling and education with individualized selection of the appropriate agent is critical to provide satisfactory outcomes. Conclusions, Clinicians must be technically proficient, balance esthetic need with facial anatomy, and consider HA properties to provide optimal outcomes. [source]

European evaluation of a new hyaluronic acid filler incorporating lidocaine

Delayed immune-mediated adverse effects related to hyaluronic acid and acrylic hydrogel dermal fillers: clinical findings, long-term follow-up and review of the literature