Abstract
During last years, hyaluronic acid- (HA-) based dermal fillers have grown rapidly and continuously, as reported by the American Society of Aesthetic Plastic Surgery (ASAPS). In fact, HA fillers are considered the gold standard technique for soft tissue augmentation, deep skin hydration, and facial recontouring, playing a key role as an alternative to plastic surgery. HA fillers are less invasive, more biocompatible, and safer and with a more natural and immediate result if compared to plastic surgery. Hence, the safety of HA-based dermal fillers plays a crucial role, mostly in terms of biocompatibility and adjustability in case of unpleasant results and side effects such as, tyndall effect, edema, or granulomas. Hyaluronidase is a naturally occurring enzyme, present in the human body, and can degrade HA fillers avoiding more severe complications. In this article, we analyzed the bioavailability of hyaluronidase degradation of five fillers of Neauvia® hydrogels line (MatexLab SA, Lugano, CH), composed of pure hyaluronic acid and based on PEGDE cross-linking (polyethylene glycol) technology that guarantees a higher biocompatibility and an optimal biointegration and rheological characteristics. The performed in vitro testing is based on the colorimetric determination of the N-acetyl-D-glucosamine (NAG) present in solution after incubation with hyaluronidase, determined at different time points in order to assess the kinetic of each product degradation (1h, 3h, 6h, 24h, 48h, 72h, 120h, and 168h). The aim of this study was to assess, in vitro, how the difference in HA content and PEGDE concentration of the analyzed fillers can influence the product biocompatibility, intended as product enzymatic clearance and duration in time. The results demonstrated that the method was reproducible and easy to perform and that all the analyzed fillers are naturally immediately available for hyaluronidase-mediated degradation.
Highlights
During last years, the demand for ever less invasive but effective techniques in the field of aesthetic medicine has increased exponentially
According to the American Society for Aesthetic Plastic Surgery (ASAPS), more than 85% of all dermal filler procedures performed in 2008 used hyaluronic acid- (HA-) based products [2] and in 2015, HA-dermal fillers accounted for more than 92% of all filler treatments in the US [7]
The use of PEGDE as a crosslinking agent is an innovation in the biomedical field and makes interesting the study of Neauvia5 PEGDE fillers in order to investigate their behavior in the presence of hyaluronidase mostly in terms of improved stability and preserved biocompatibility
Summary
The demand for ever less invasive but effective techniques in the field of aesthetic medicine has increased exponentially. This trend has stimulated the use of intradermal fillers as a gold standard method to increase soft tissue volume, at the expense of plastic surgery, a technique considered much more invasive [1,2,3,4]. According to data from the American Society for Aesthetic Plastic Surgery (ASAPS), more than 1.6 million dermal filler treatments were performed in 2011, making them the second. According to the ASAPS, more than 85% of all dermal filler procedures performed in 2008 used hyaluronic acid- (HA-) based products [2] and in 2015, HA-dermal fillers accounted for more than 92% of all filler treatments in the US [7]
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