Follow up study of dermal hyaluronic acid injection by high frequency ultrasound and magnetic resonance imaging

Abstract

In the last few years, increasing use of injectable resorbable fillings has been reported for facial wrinkle treatment and for soft tissue augmentation of HIV-associated facial lipodystrophy [ 1 Buck D.W. Alam M. Kim J.Y.S. Injectable fillers for facial rejuvenation: a review. J Plast Reconstr Aesthet Surg. 2009 Jan; 62: 11-18 Abstract Full Text Full Text PDF PubMed Scopus (112) Google Scholar , 2 Gooderham M. Solish N. Use of hyaluronic acid for soft tissue augmentation of HIV-associated facial lipodystrophy. Dermatol Surg. 2005 Jan; 31: 104-108 Crossref PubMed Scopus (31) Google Scholar ]. However, important practical information concerning the localization and subsequent diffusion of the injected product in skin tissues are poorly documented. Histological analysis has been previously used to compare different kinds of fillers [ [3] Lemperle G. Morhenn V. Charrier U. Human histology and persistence of various injectable filler substances for soft tissue augmentation. Aesthetic Plast Surg. 2003; 27: 354-366 Crossref PubMed Scopus (399) Google Scholar ], to evaluate remanescence of the injected material [ [4] Duranti F. Salti G. Bovani B. Calandra M. Rosati M.L. Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study. Dermatol Surg. 1998; 24: 1317-1325 Crossref PubMed Scopus (413) Google Scholar ], or to observe the product placement at the injection site [ [5] Arlette J.P. Trotter M.J. Anatomic location of hyaluronic acid filler material injected into nasolabial fold: a histologic study. Dermatol Surg. 2008; 34 (discussion S62-3: S56–S62): S56-S62 Crossref PubMed Scopus (49) Google Scholar ]. Wang et al. have recently proposed a mechanism in which the filler-induced mechanical tension solicits local fibroblasts and activates collagen synthesis [ [6] Wang F. Garza L.A. Kang S. Varani J. Orringer J.S. Fisher G.J. et al. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol. 2007; 143: 155-163 Crossref PubMed Scopus (356) Google Scholar ].