Gel Properties of Hyaluronic Acid Dermal Fillers

Edsman, Katarina; Nord, Lars I.; Öhrlund, Åke; Lärkner, Helena; Kenne, Anne Helander

doi:10.1111/j.1524-4725.2012.02472.x

Cited by 155 publications

(142 citation statements)

References 12 publications

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…The HA fillers studied are based on two different technologies, the OBT and the NASHA technology. The NASHA technology produces firmer gels based on molecular entanglements and small amounts of chemical crosslinking, with controlled particle sizes at different levels [12]. The OBT technology is based on four different levels of crosslinking, producing gels from very soft to intermediately firm, providing different levels of tissue support [13].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Rheometry Amplitude Sweep Cross-Over Point as an Index of Flexibility for HA Fillers

Öhrlund¹

2018

JCDSA

Self Cite

View full text Add to dashboard Cite

Background: The majority of studies published on rheology of hyaluronic acid (HA) fillers have focused on results from frequency sweeps within the linear viscoelastic region (LVR), i.e. at nearly static conditions. To study the properties and behavior of HA fillers at more dynamic conditions, it is necessary to go outside the LVR. Objective: Evaluation of the G'/G'' cross-over point from the amplitude sweep is suggested as a manner to estimate the flexibility of HA fillers. Materials and methods: Rheological properties of 7 HA fillers were measured in an amplitude sweep from 0.1% to 10000% strain at 1 Hz, using an Anton Paar MCR 301, a PP-25 measuring system with a gap of 1 mm at 25˚C and a 30-min relaxation time. The cross-over point was evaluated for stress, strain and G (G' and G'' identical), the values denoted xStrain, xStress and xG. Results: The xStrain values spanned from below 1000% to above 2000% for the products based on the Optimal Balance Technology (OBT)™ (in the US, XpresHAn Technology™), compared to below 100% for the products based on the NASHA® technology. Conclusions: Measurement of the flexibility provides a more complete picture of the rheological properties of HA fillers as a complement to firmness measured as G'. The test results show that the Restylane family of products covers a large range in flexibility, and that the flexibility can be estimated using xStrain derived from the amplitude sweep.

show abstract

Section: Methodsmentioning

confidence: 99%

Evaluation of Rheometry Amplitude Sweep Cross-Over Point as an Index of Flexibility for HA Fillers

Öhrlund¹

2018

JCDSA

Self Cite

View full text Add to dashboard Cite

show abstract

“…For example, the enzyme hyaluronidase can be used to degrade hyaluronic acid fillers in the skin if overcorrection is performed or a strong immune response occurs. However, several cases have been reported where it seemed to be impossible to degrade the filler completely with the enzyme [72]. A possible explanation could be that the hyaluronic acid material is modified to such an extent that the enzyme does not recognize the hyaluronic acid filler [72].…”

Section: Keratoacanthoma-like Reactionmentioning

confidence: 99%

“…However, several cases have been reported where it seemed to be impossible to degrade the filler completely with the enzyme [72]. A possible explanation could be that the hyaluronic acid material is modified to such an extent that the enzyme does not recognize the hyaluronic acid filler [72]. If product safety and application methodology are not evaluated sufficiently thorough before as well as after introduction on the market, or if the products are injected by insufficiently trained physicians, an increase in the occurrence of complications with injectable fillers can be expected, especially in view of the expected increase in the number of treatments with a wider range of available products.…”

Section: Keratoacanthoma-like Reactionmentioning

confidence: 99%

Clinical data on injectable tissue fillers: a review

Vries

Geertsma

2013

Expert Review of Medical Devices

View full text Add to dashboard Cite

Treatment with injectable tissue fillers for aesthetic purposes is increasingly popular. In parallel with this success, questions related to the safety of these treatments and the products involved are being raised more prominently. To gain insight in the safety aspects of injectable tissue fillers, we performed a literature review to collect studies reporting clinical data of injectable tissue fillers. We found several case reports where serious complications after more than three years are described. However, there are only a limited number of well-defined prospective clinical studies available with follow-up periods longer than three years. Furthermore, causes of complications, that is, treatment or product related, are often not specified in literature. Considering the intended functional period of fillers in combination with the known occurrence of long-term complications, there is a need for well-defined prospective clinical studies. In order to be able to discriminate between product failure (a product safety issue) or application methodology (a physician expertise or training issue), better identification of observed complications and whether they are product or treatment related, is needed. For the safe use of the fillers it is important that treatment with injectable tissue fillers is performed by a trained physician, who knows the product specifications and its applications. . Moreover, it is expected that due to increase in life expectancy, the demand for anti-aging treatments, like tissue augmentation with injectable tissue fillers, will grow [2]. Their success has been attributed to the fact that treatments with injectable tissue fillers are fast and appear to be relatively easy [2]. Only a relatively 'simple' subcutaneous injection is needed. Today, various injectable tissue fillers with different characteristics are available, for example, duration of the effect, material type and intended anatomical location.Although the application of an injectable tissue filler seems to be relatively simple and safe, reports of serious adverse effects have appeared in the literature [2][3][4][5][6][7][8]. Estimates of the occurrence of severe complications after treatment with various types of injectable tissue fillers range between 1:80 and 1:50,000 patients [9,10]. Adverse side effects can be caused by incorrect injection techniques (treatment related) or by the characteristics of the products (product related) [11,12]. Short-, mid-and long-term complications can be discerned (TABLE 1) [2,13-15]. Short-term complications like pain, swelling, fever, immediate hypersensitivity reactions, occur immediately or within several days past treatment and disappear after several weeks. A more severe short-term complication is necrosis [5,16]. Necrosis occurs immediately or within a few days if blood vessels are obstructed by the filler material or if they are injured during the treatment [17]. Mid-term complications such as delayed inflammatory reactions, ulceration and granuloma reaction may occur after 2-12 months. I...

show abstract

“…The crosslinking process enables to chemically bind linear HA polymer chains together, transforming them into a threedimensional network [10]. In aesthetic medicine, most of the available HA soft-tissue fillers are manufactured using 1,4-butanediol diglycidyl ether (BDDE) as a crosslinking agent, due to its low toxicity compared to other crosslinkers like 1,8-diepoxyoctane (DEO) or divinylsulfone (DVS).…”

Section: Introductionmentioning

confidence: 99%

Influence of the Macro- and/or Microstructure of Cross-Linked Hyaluronic Acid Hydrogels on the Release of Two Model Drugs

Mondon¹,

Dadras²

2016

J Glycobiol

View full text Add to dashboard Cite

Injectable hyaluronic acid (HA) hydrogels, crosslinked with 1,4-butanediol diglycidyl ether (BDDE), are widely used in aesthetic medicine. Due to their high clinical tolerance, HA hydrogels are thought to be applicable as injectable drug delivery systems. Here, HA matrix structures of BDDE-crosslinked HA hydrogels were analysed, and the effects of the structures on the release of two model drugs were assessed. Seven crosslinked HA hydrogels were observed by optical microscopy and cryo scanning electron microscopy (cryo-SEM). We observed three specific matrix macrostructures under optical microscopy: two had a "spider web"-like structure, three had a particulate structure, and two had an intermediate structure. These differences were less evident under cryo-SEM, where all hydrogels exhibited fibrous microstructures of different homogeneity levels, with pore sizes between 0.5 and 18 μm. Three cross-linked HA hydrogels with different macrostructures were loaded with bovine serum albumin (BSA) and lidocaine to assess their capacities to release drug over 4 days. No differences in drug release were observed between gels, and BSA was released for up to 4 days, which was four times longer than lidocaine. Thus, BDDEcrosslinked HA hydrogels could be applied as an injectable drug delivery system, particularly for the delivery of high-molecular-weight molecules.

show abstract

Gel Properties of Hyaluronic Acid Dermal Fillers

Cited by 155 publications

References 12 publications

Evaluation of Rheometry Amplitude Sweep Cross-Over Point as an Index of Flexibility for HA Fillers

Evaluation of Rheometry Amplitude Sweep Cross-Over Point as an Index of Flexibility for HA Fillers

Clinical data on injectable tissue fillers: a review

Influence of the Macro- and/or Microstructure of Cross-Linked Hyaluronic Acid Hydrogels on the Release of Two Model Drugs

Contact Info

Product

Resources

About