The development of new drugs to counter human immunodeficiency virus (HIV) infection has led to an increase in lipodystrophic syndrome among HIV-infected individuals receiving combination therapy. Bio-Alcamid(TM) is a recently developed polymeric substance that can be implanted to compensate for adipose effects. We have implanted this substance in 73 patients with up to three years' follow-up. The aesthetic results were deemed excellent by both physicians and patients. No implant dislocation, implant migration, granuloma, allergic reaction or intolerance were recorded.
BACKGROUND
Three new hyaluronic acid (HA)-based fillers made of long chains crosslinked with reduced amounts of 1,4-butanediol diglycidyl ether (BDDE) were developed for the treatment of dynamic facial areas. Their resilience and increased stretching ability were optimized to ease injectors' practice and provide patients with most natural aesthetic results.
OBJECTIVE
This study aimed at evaluating the efficacy, durability, and safety of these resilient HA fillers versus commercially available comparator gels.
METHODS
A prospective, monocentric, split-face, double-blinded, randomized, controlled trial was performed on 90 subjects presenting moderate to severe bilateral nasolabial folds (NLFs). Efficacy parameters were assessed over 18 months, including improvement on the Wrinkle Severity Rating Scale and Global Aesthetic Improvement Scale, as well as quantitative imaging and analysis of NLF correction. Physicians' and subjects' satisfaction, together with safety, were assessed throughout the study.
RESULTS
The new HA fillers offered efficacy and safety profiles at least equivalent to comparators. These dynamic facial fillers elicited higher satisfaction immediately after injection but also on the long run, according to both investigators and subjects.
CONCLUSION
This pilot trial demonstrated the numerous benefits of 3 new resilient HA fillers with decreased BDDE crosslinking in the treatment of dynamic wrinkles.
For malar augmentation procedures with Restylane SubQ, the transoral route of injection offers some advantages over the transdermal route. It allows ready access to the zygomatic periosteum, avoids the need for identification of soft tissue fascia planes and detachment of muscle, and reduces the risk of damage to important nerves and blood vessels and resulting hematoma. By using the transoral technique, the possibility of visible local complications (edema and ecchymosis) can be reduced. Use of this injection route does not appear to increase the risk of introducing infection into the soft tissues, and prophylactic antibiotic use is considered unnecessary, although good oral hygiene is important and mouth washing should be encouraged. In summary, the transoral method of Restylane SubQ injection is as reliable as the transdermal route, and this approach is likely to appeal to patients because of its lower risk of inflammatory reactions following treatment.
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