Consensus Recommendations for Soft-Tissue Augmentation with Nonanimal Stabilized Hyaluronic Acid (Restylane)

Abstract

The American Society for Aesthetic Plastic Surgery recently reported that there were nearly 12 million cosmetic procedures (2.1 million surgical and 9.7 million nonsurgical) performed in the United States in 2004. Almost 900,000 of the nonsurgical procedures were soft-tissue augmentation procedures using hyaluronic acid fillers. Restylane (Medicis Aesthetics, Inc., Scottsdale, Ariz.), nonanimal stabilized hyaluronic acid, was approved for use in the United States in December of 2003. Although the use of all fillers increased from 2003 to 2004, use of hyaluronic acid fillers increased nearly 700 percent. The dramatic increase in all cosmetic procedures reflects the growing trend, especially with increasing job competition, to maintain a youthful lifestyle and appearance. Basic recommendations for aesthetic use of Restylane were established based on short- and long-term efficacy and safety studies (Medicis Aesthetics, package insert). With the widespread and growing use of Restylane, a cross-sectional panel of experts with extensive clinical experience, including cosmetic dermatologists and surgical specialists (cosmetic, plastic, and ocular), convened to develop consensus guidelines for the use of Restylane. This supplement reviews the aesthetic affects of aging on the face, the role of fillers in facial soft-tissue volume replacement, and general principles for the use of Restylane, including patient comfort and assessment techniques. Specific recommendations for Restylane use in each potential target area, including type of anesthesia, injection techniques, volume for injection, use in combination with other procedures, and expected longevity of corrections, are provided. Techniques for optimizing patient outcomes and satisfaction and for minimizing and managing expected problems and potential complications are described.

Nonanimal Stabilized Hyaluronic Acid for Tissue Augmentation of the Dorsal Hands: A Prospective Study on 38 Patients

“…Our results after injection of nonanimal stabilized HA in the dorsum of the hands have shown significant clearance of rhytids, veins, bony prominences, and dermal and subcutaneous atrophy for all periods of observation. These results are partly explained by the fact that HA is able to hold up to 500-1,000 times its own weight of water in the extracellular matrix of the dermis [18]. In this context, Williams et al [14], using a suction elasticity meter and moisture-measuring device, have clearly demonstrated an increase in cutaneous elasticity and stratum corneum hydration after stabilized HA injection in the dorsum of the hand.…”

Tratamento dos sulcos palpebromalar e nasojugal com ácido hialurônico

“…O ácido hialurônico (Restylane ® ) foi escolhido por ser uma molécula presente em diferentes tecidos, entre eles no tecido conjuntivo, na derme, nas articulações e no vítreo; e por ser o produto que mais se aproxima do produto ideal (11) . O ácido hialurônico é formado por uma cadeia longa polissacarídea, subdividido em unidades dissacarídeas repetidas de ácido urônico e N-acetil-glicosamina.…”

“…O ácido hialurônico é formado por uma cadeia longa polissacarídea, subdividido em unidades dissacarídeas repetidas de ácido urônico e N-acetil-glicosamina. O Restylane ® é um ácido hialurôni-co de origem não animal, obtido a partir da fermentação de cepas de Streptococcus (S. equi ou S. zooepidemicus) e estabilizado por processo químico de ligações cruzadas ("cross-linked") (11) .…”

Estudio clínico de eficacia, duración y efectos adversos del implante de ácido hialurónico en área buco-maxilo-facial

“…8). According to some sources used, the prevalence of adverse effects to HA is estimated to be below 1% (79) and for others, according to the brand employed, it is up to 3% (80) , with the effects being easily manageable and without consequences (5,12) . For this study we have considered the definitions given by WHO (81) and PAHO (82) to "adverse reaction: a response to a drug, which is noxious and unintended, and which occurs at doses normally used in humans for the prophylaxis, therapy...".…”