Soft tissue augmentation in dermatology - 2009 update

Abstract

The number of products available to dermatologists for soft tissue augmentation has grown significantly over the past several years in the US. This manuscript will review the various hyaluronic acid fillers and other Food and Drug Administration -approved products we are utilizing for our patients in the rejuvenation process. It is hoped that through this article clinicians will feel more comfortable using these products in their everyday practice of dermatology.

Efficacy and Safety of and Patient Satisfaction with Injectable Hyaluronic Acid with 0.3% Lidocaine Hydrochloride for the Treatment of Superficial Perioral Lines or Superficial Lateral Canthal Lines

“…The Food and Drug Administration has approved injectable nonanimal stabilized HA (NASHA) that contains 5.5 mg/mL of HA and comes premixed with 0.3% lidocaine hydrochloride (Prevelle Silk, Mentor Worldwide LLC, Santa Barbara, CA and Genzyme Corporation, Cambridge, MA) for the correction of moderate to severe facial wrinkles and folds. It is 98% cross‐linked with divinyl sulphone to create a non‐water soluble gel, which is meant to make the molecule less susceptible to degradation than HA fillers with 75% or 15.0 mg/mL of cross‐linked HA gel component (Restylane and Perlane, Q‐Med, Uppsala, Sweden) and 60% or 14.4 mg/mL of cross‐linked HA gel component (Juvederm Ultra Plus, Allergan, Irvine, CA) and has a gel particle size of 350 μm . This gel combines HA with 0.3% lidocaine to decrease pain on injection and is generally preferred for patients needing instant correction of fine lines …”

“…It is 98% cross-linked with divinyl sulphone to create a non-water soluble gel, which is meant to make the molecule less susceptible to degradation than HA fillers with 75% or 15.0 mg/mL of crosslinked HA gel component (Restylane and Perlane, Q-Med, Uppsala, Sweden) and 60% or 14.4 mg/mL of cross-linked HA gel component (Juvederm Ultra Plus, Allergan, Irvine, CA) 1-3 and has a gel particle size of 350 lm. 2 This gel combines HA with 0.3% lidocaine to decrease pain on injection and is generally preferred for patients needing instant correction of fine lines. 3 There are several injectable NASHAs that vary in properties such as gel hardness (G′), crosslinking, gel consistency, particle size, and duration of effect.…”

Minimally invasive esthetic procedures of the male breast

“…Loss of adipose tissue and in part glandular tissue can also be managed by body sculpturing techniques, i.e., dermal fillers and other volumetric techniques. Based on safety, efficacy, and the individual needs of the patient, hyaluronic acid (HA)‐based fillers are used most widely 27,28 …”

Granulomatous Reaction to Hyaluronic Acid: A Case Series and Review of the Literature

“…1 HA is a polysaccharide consisting of repeated Dglucuronic acid and D-N-acetylglucosamine disaccharide units. 5 Prevelle Silk combines HA with 0.3% lidocaine to decrease pain on injection and is generally preferred over other HA filters for patients needing instant correction of fine lines. 2 Two types of HA fillers are available, those derived from rooster combs and those produced from bacterial fermentation by Streptococcus species.…”

“…Because the chemical structure is the same in all species, implant rejection and immune reactions are low. 5 We present three patients who were part of a clinical trial investigating the efficacy and safety of and patient satisfaction with HA with lidocaine for superficial, vertical perioral and superficial, horizontal, lateral canthal lines. 3 Prevelle Silk (Mentor Worldwide LLC, Santa Barbara, CA, and Genzyme Corporation, Cambridge, MA) is a nonanimal stabilized HA (NASHA) product that contains 5.5 mg/mL of HA.…”