Cross‐linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios

Rauso, Raffaele; Zerbinati, Nicola; Franco, Renato; Chirico, Fabrizio; Ronchi, Andrea; Sesenna, Enrico; Colella, Giuseppe; Tartaro, Gianpaolo

doi:10.1111/dth.13269

Cited by 24 publications

(26 citation statements)

References 30 publications

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“…Hyaluronic acid (HA) fillers are the most used worldwide, this is mainly related to the high biocompatibility and safety profile of HA, moreover, HA is the only substance that can be "dissolved" thanks to the use of hyaluronidase (HYAL) that induce an enzymatic hydrolytic effect [1], [2], [3], [4], [5]. The possibility to hydrolyze HA, once injected, is useful in cases of unpleasant results, however, its main advantage is related to the possibility to treat unwanted side effects such as nodules, and especially vascular problems such as impending necrosis [6], [7].…”

Section: Introductionmentioning

confidence: 99%

Clinical Experience with PEGylated Hyaluronic Acid Fillers: A 3-year Retrospective Study

Rauso

Nicoletti

Bove³

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Hyaluronic acid fillers are the most used worldwide, thanks to the high biocompatibility and safety profile of HA and it is also the only substance that can be “dissolved” due to the hyaluronidase effect. AIM: A retrospective clinical evaluation of the outcomes following PEG cross-linked HA-based filler injection was performed. METHODS: Data were collected from December 2017 to June 2020. A total of 65 patients (12 M, 53 F), age ranging 28–62 year’s old (mean age 42.3), were treated. Exclusion criteria were applied and in accord to treatment plan, were used specific site injections and fillers. Follow-up was evaluated between 6 months and 2 years. RESULTS: A total of 61 treatments using 124 vials of HA filler crosslinked with PEG were performed. CONCLUSION: In conclusion, from 2014, HA fillers having PEG as cross-linker agent have been introduced in the european market. Several papers have been published in order to evaluate the features of these fillers, although, to the best of our knowledge, this is the first clinical paper regarding their use.

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Section: Introductionmentioning

confidence: 99%

Clinical Experience with PEGylated Hyaluronic Acid Fillers: A 3-year Retrospective Study

Rauso

Nicoletti

Bove³

et al. 2021

Open Access Maced J Med Sci

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“… Note: Data from King et al 89 and Rauso et al 90 , 91 Abbreviation: HDPH, high dose pulse hyaluronidase. …”

Section: Introductionmentioning

confidence: 99%

“…ConsentMandatory informed consent: aesthetic use may be off-label; check country-specific recommendations Note: Data from King et al89 and Rauso et al90,91 Abbreviation: HDPH, high dose pulse hyaluronidase.…”

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confidence: 99%

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Heydenrych

Boulle

Kapoor³

et al. 2021

CCID

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Dermal filler treatments require constant reassessment for improving and safeguarding the rapidly evolving aesthetic field. Suboptimal injection technique, patient selection and product knowledge have touted a concerning increase in filler complications, with new challenges such as the COVID-19 pandemic leading to new paradigms in the understanding, prevention, diagnosis and treatment of complications. The updated 10-point plan has been developed to curtail complications through consideration of causative factors, categorized as patient, product, and procedure-related. Patient-related factors include a preprocedural consultation with careful elucidation of skin conditions (acne, rosacea, dermatitis), systemic disease (allergies, autoimmune disease, underlying bacterial and viral disease (herpes simplex virus, COVID-19 infection), medications (antineoplastic drugs, recreational drugs) and previous cosmetic procedures (including fillers and energy-based devices). Patient assessment should include standardized photography and also evaluate the role of social media, ethnicity, gender, generational, and LGBTQ+ needs. Specified informed consent for both adverse events and their treatment is essential due to the increase in vascular complications, including the risk of blindness. Product-related factors include the powerful advantage of reversibility when using hyaluronic acid (HA) products. Product characteristics such as molecular weight and filler degradation should be understood. Product layering over late or minimally degradable fillers is still inadvisable due to the initial filler being teased into reactivity. Procedural factors such as consistent photographic documentation, procedural planning, aseptic non-touch technique (ANTT), knowledge of topographical anatomy and angiosomes, and technical dexterity including pinch anatomy and needle skills are of pivotal importance. The final section is dedicated to algorithms and checklists for managing and treating complications such as allergic hypersensitivity reactions, vascular events, infection, edema and late-onset adverse events (LOAEs). The updated 10-point plan is a methodical strategy aimed at further minimising the risk of dermal filler complications.

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“…Unlike surgical approaches, they can be performed in an outpatient setting; furthermore, they have no associated donor site morbidity and no risk of graft hypertrophy, and they can be molded, with the potential for complete reversibility and minimal risk of lumpiness, bruising, or infection. If patients are disappointed with the results or complications to occur, HA can be dissolved easily and quickly by hyaluronidase injections, giving an edge over other fillers [32][33][34]. Furthermore, many of the patients we treated for this condition underwent multiple surgical procedures in the past, and they might prefer a less invasive alternative.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

Migliardi¹,

Modugno²,

Chirico

et al. 2021

Eur J Plast Surg

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Background One of the primary goals of enucleation and evisceration surgery is the restoration of an adequate orbital volume through the use of appropriately sized alloplastic or autogenous tissues. In patients inadequately treated, post-enucleation or evisceration socket syndrome occurs. Fillers are an ideal alternative for eyelid and eyebrow arcade volume enhancement since their injection is easily performed in an outpatient setting avoiding several complications. The aim of this study is to report the use of hyaluronic acid (HA) fillers to treat volume deficits of the upper and lower eyelids, projecting the brow arcade and reducing the asymmetry. Methods Thirteen patients (2 male, 11 female, mean age 32.7 years) were treated from June 2012 to May 2020. Non-surgical treatment by HA filler injection for aesthetic rehabilitation of deep superior sulcus, inferior tear trough deformity, and scleral show was performed. Results No complications as orbital-ache and/or vasovagal response were reported during the injections. Minor complications such as light swelling at the site of injection, self-resolved within 2 days, were recorded. Stable results were observed at follow-ups. In two cases, two successive treatments were required at 3 and 6 years from the first injection. Conclusions Hyaluronic acid fillers offer a versatile and safe method for replacing soft tissue lost from the upper eyelid/brow complex in cases of post-enucleation or evisceration socket syndrome. Level of evidence: Level IV, therapeutic study.

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Cross‐linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios

Cited by 24 publications

References 30 publications

Clinical Experience with PEGylated Hyaluronic Acid Fillers: A 3-year Retrospective Study

Clinical Experience with PEGylated Hyaluronic Acid Fillers: A 3-year Retrospective Study

The 10-Point Plan 2021: Updated Concepts for Improved Procedural Safety During Facial Filler Treatments

Hyaluronic acid injections in post-enucleation or evisceration socket syndrome: a case series

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