Global facial rejuvenation with hyaluronic acid: a safe set of directives to whole-approach of the aging-changes evaluated by magnetic resonance imaging

Abstract

Background: Face rejuvenation with hyaluronic acid (FR-HA) through a global approach was performed in a single session, by using a safe set of directives targeted for each facial zone. Methods: FR-HA was performed with products of the QTFill Signature® range all of them with same HA-concentration and molecular-weight, with two crosslinking technologies, the own Ultra-High-Density™ crosslinking and BDDE-crosslinking with tree degrees of BDDE, resulting in high-, medium- and low-G', and 3.0% of lidocaine hydrochloride. Bolus injection with needle and retrograde-backflow injection with microcannula or needle were directed to specific facial zones. A safe FR-HA protocol based on HA-products, fat layers and vasculature, and points and techniques of injection recovered the face youthful appearance. Results: FR-HA was made for eleven facial zones, patient average of 6.95±1.30, average of 30.55±0.74 injections-points per facial-zone and of 16.80±0.83 injections-points per patient. The volume of HA injected was 49.50 ml, average of 4.50±0.37 ml per facial zone and 2.48±0.12 ml per patient. From one-month to twelve-months there was no significant differences on the face appearance and on density of the gel-diffusion displayed by MRI in T2-weighted with fat suppression on axial and coronal planes, which were endorsed by the Facelift Outcomes Evaluation questionnaire scores. Conclusions: Minimal changes on clinical outcomes and slow degradation of gel-diffusion on MRI in T2-weighted with fat suppression on axial and coronal planes from one-month to twelve-months showed that the HA-products remained stable in the injection site without evidence of significant resorption or loss of correction, indicating FR-HA efficacy and long-lasting.