Injectable Hyaluronic Acid Implant for Malar and Mental Enhancement

Lowe, Nicholas J.; Grover, Rajiv

doi:10.1111/j.1524-4725.2006.32190.x

Cited by 26 publications

(28 citation statements)

References 12 publications

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“…Similar long-term effects with Restylane SubQ treatment in non-HIV-positive patients of up to 12 months have been described for cheek and chin augmentation [13,19] and in a small study on orbital volume enhancement [22]. However, apart from one study [14], efficacy results have only used subjective data.…”

Section: Durabilitymentioning

confidence: 63%

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

Skeie¹,

Bugge

Negaard

et al. 2010

HIV Medicine

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ObjectivesFacial 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 SubQ 2. 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. ResultsSeventeen patients remained at 36 months. Mean (AE standard deviation) total cutaneous thickness increased from 6 AE 1 mm at baseline to 12 AE 1 mm (Po0.001) at 36 months. Response rate (total cutaneous thickness 410 mm) was 70%. Fifteen patients classified their facial appearance as very much or moderately improved. VAS increased from 39 AE 25 to 70 AE 20 (Po0.05) 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. ConclusionsOur 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. IntroductionLipoatrophy is a particularly distressing aspect of lipodystrophy evident in HIV-positive patients on antiretroviral therapy (ART). Facial lipoatrophy can severely affect patients' quality of life and may contribute to reduced antiretroviral (AVR) adherence [1]. Furthermore, the stigmatization affected patients may encounter as a result of facial lipoatrophy can be detrimental for self-esteem [2]. Treatment strategies include switching AVR regimens, prescription of medication, insertion of surgical implants and injection of dermal fillers.While there is evidence that the use of new nonthymidine nucleoside reverse transcriptase inhibitors can prevent the development of lipoatrophy, switching medications, after lipoatrophy has progressed, offers only limited benefit [3,4]. A follow-up study of the Oslo HIV Cohort Study 2000 found that facial atrophy was less reversible than fat atrophy of the extremities [5]. Medications such as pioglitazone [6], uridine [7] and pravastatin [8] have been shown to have some effect on limb lipoatrophy in HIV-infected patients; however, the mechanisms by which they work and their potential side effects are not well documented.In the absence of a therapeutic intervention to reverse lipoatrophy, injection of soft-tissue fillers appears to be the simplest way to correct facial lipoatrophy. Many soft-tissue fillers, both biodegradable and permanent, have been studied in HIV facial lipoatrophy, however, long-term clinical safety and efficacy data are lacking. Biodegradable fillers have a good safety profile, but treatment with s...

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Section: Durabilitymentioning

confidence: 63%

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

Skeie¹,

Bugge

Negaard

et al. 2010

HIV Medicine

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“…HA is a non-antigenic, immunocompatible extracellular macromolecule [19,20] which has already demonstrated prevalent medical use as an injectible gel for viscosupplementation of osteoarthritic joints [21,22] and as a dermatological treatment for wrinkles [23][24][25]. Because of its hydroxyl and carboxylic acid groups, HA is easily modified to achieve particular characteristics and easily crosslinked to form hydrogels [26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

The effect of hyaluronic acid size and concentration on branching morphogenesis and tubule differentiation in developing kidney culture systems: Potential applications to engineering of renal tissues

2007

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Hyaluronic acid (HA) is a glycosaminoglycan of tissue engineering importance that plays a vital role in mammalian development. In vitro kidney culture methods were utilized to investigate the importance of HA during renal organogenesis. We found that HA has the ability to simultaneously modulate ureteric bud (UB) branching, promote mesenchymal-to-epithelial transformation, and promote differentiation of both metanephric mesenchyme (MM) and the UB depending on the concentration and molecular weight (MW) of HA. Hyaluronidase inhibited branching morphogenesis in both isolated UB and whole kidney cultures, suggesting endogenous HA is required for branching morphogenesis. HA exhibited morphogen-like properties, stimulating branching morphogenesis at low concentrations (0.1%) and low MW (6.55 kDa) but inhibiting at high concentrations (3.75%) and high MW (234.4 kDa). Furthermore, HA of every MW tested promoted collecting duct differentiation as measured by AQP-2 expression. E-cadherin immunostaining and qPCR of nephron differentiation markers (OAT-1, NaP i -2, AQP-1, and THP), demonstrated that HA of a variety of MWs strongly promotes mesenchymal epithelialization and nephron differentiation in a concentration-dependent manner. Since the HA synthesis and degradation genes, has-2 and hyal-2, are highly expressed during kidney development, this data suggests that specific sizes and concentrations of HA may act to independently regulate UB branching and promote tubular maturation, representing a potential switch for ending branching morphogenesis, as well as initiating nephron differentiation. In addition, the ability of HA to promote in vitro embryonic kidney growth and maturation, together with the biocompatibility and crosslinking capability of HA, suggests a potential use of HA for both creating an instructive, 3D scaffold for in vitro kidney engineering from developmental tissues, as well as promoting tubule regeneration in injured or cryopreserved kidneys.

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“…As we age, we start losing our youthful facial volume, which contributes to the formation of folds and wrinkles. Dermal fillers contain hyaluronic acid, which is a natural substance that binds tightly to water [12,13]. These fillers replace lost volume and restore youthful contours to the skin by smoothing facial wrinkles and folds.…”

Section: Department Of Dermatology and Venereology Punjab Health Sysmentioning

confidence: 99%

Is beauty skin deep – an approach to a beautiful face

Puri¹

2014

Our Dermatol Online

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Injectable Hyaluronic Acid Implant for Malar and Mental Enhancement

Abstract: Restylane SubQ is a useful injectable agent to augment and lift upper cheeks and recontour chins. Further efficacy studies seem justified.

Cited by 26 publications

References 12 publications

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

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

The effect of hyaluronic acid size and concentration on branching morphogenesis and tubule differentiation in developing kidney culture systems: Potential applications to engineering of renal tissues

Is beauty skin deep – an approach to a beautiful face

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