Acid-based Gel Of Nonanimal Origin Research Articles

Rejuvenation effects of hyaluronic acid injection on nasojugal groove: Prospective randomized split face clinical controlled study

Background: Pronounced nasojugal groove (tear trough deformity) is one of the landmarks of aging. Hyaluronic acid filler can be used for attenuating the nasojugal sulcus but irregular lumpness and overcorrection are common adverse reactions. Objectives: We evaluated the effect of Restylane Vital® with its specialized injector on volume correction and skin tone of nasojugal groove. Subjects and method: Ten Korean women were enrolled in this study. Subjects were randomized to be injected a stabilized hyaluronic acid-based gel of nonanimal origin (NAHSA injector, Restylane Vital®, Q-med) on one side of nasojugal groove, with the other side paired as control. The treatment was performed in one session. Outcome assessments included standardized photography, mexameter, and spectrometer for skin tone, global evaluation by blinded investigators, and patients’ self-assessment. An assessment was made before treatment, immediately after treatment, and 1, 3, and 6 months after the treatment. Results: All patients reported a high degree of satisfaction. Duration of overall effect varied among the patients. Correction of the nasojugal groove with a Restylane Vital® injector causes minimal tissue trauma and allows exact placement of hyaluronic acid. Restylane Vital® injector offers more predictable results and a lower incidence of adverse effects than more commonly used techniques. Conclusions: Hyaluronic acid filler intradermal injection with special injector is a safe and effective method for correction of nasojugal groove.

Vergleichsuntersuchung eines monophasischen CPM- und eines biphasischen NASHA-Fillers zur Korrektur der Nasolabialfalten

<b>Hintergrund: </b>Behandlungen mit Hyaluronsäure (HA) zählen zu den am häufigsten eingesetzten minimal-invasiven Verfahren zur Augmentation von Falten und Volumendefiziten. Es gibt jedoch eine große Anzahl an verschiedenen Produkten, die wesentliche Unterschiede in der Art der Herstellung und der damit verbundenen Eigenschaften aufweisen. <b>Zielsetzung:</b> Ziel der Studie war die intraindividuelle In-vivo-Evaluierung der Effekte eines monophasischen HA-Fillers mit Cohesive Polydensified Matrix (CPM^®) mit denen eines biphasischen, nicht-animalischen, stabilisierten HA-Fillers (NASHA^®) auf die Patientenwahrnehmung. <b>Methoden:</b> In den randomisierten, doppelblinden Halbseitenvergleich wurden 20 Patienten im Alter von 35 bis 65 Jahren mit einer symmetrischen Ausprägung der Nasolabialfalten (WSRS für NLF Grad 3 – 4) eingeschlossen. Die Patienten wurden einmalig mit einem monophasischen CPMHA-Filler und einem biphasischen NASHA-Filler zu gleichen Injektionsvolumina behandelt; touch-ups waren nicht erlaubt. Mittels validierter Scores wurde 2, 24 und 48 Wochen nach Studienbeginn die Faltentiefe und die ästhetische Verbesserung durch den Prüfarzt ermittelt (WSRS, GAIS) und anhand verblindeter Fotos die Faltentiefe durch einen Independent Rater beurteilt (Merz-Scale). Zudem wurde eine Patientenselbstbeurteilung erhoben (Injektionsempfinden, WSRS, GAIS, Patientenzufriedenheit). <b>Ergebnisse: </b>Die Daten von 20 Patienten (52 ± 5,6 Jahre) dokumentierten eine signifikant geringere Schmerzempfindung bei Injektion des monophasischen HA-Präparates (p ≤ 0,011). Eine signifikant verbesserte Patientenzufriedenheit zeigte sich mit beiden HA-Produkten bis zu 48 Wochen, jedoch ergaben sich signifikante Unterschiede zugunsten des monophasischen CPMHA-Fillers nach 24 und 48 Wochen (p = 0,002, p = 0,005). Eine signifikant bessere Bewertung der Faltentiefe (WSRS) und ästhetischen Verbesserung (GAIS) durch die Patienten zeigte sich 2 Wochen nach Injektion des monophasischen CPMHA-Produktes (p ≤ 0,012, p ≤ 0,011), während nach 24 und 48 Wochen ähnlich signifikante Ergebnisse auftraten. Die Beurteilung der ästhetischen Verbesserung der NLF durch den Prüfarzt dokumentierte nach 2 Wochen signifikant bessere Effekte des monophasischen HA-Produktes (p ≤ 0,025), während nach 24 und 48 Wochen ähnlich signifikante Ergebnisse auftraten. Die vom Independent Rater mittels Merz-Scale gescorte Ausprägung der NLF zeigte nach 2 und 24 Wochen eine ähnlich signifikante Reduzierung der NLF mit beiden Prüfprodukten, während sich nach 48 Wochen nur die CPMHA-injizierte NLF signifikant verminderte (p = 0,034). Das WSRS-Prüfarzt-Rating ergab eine signifikant verringerte Faltentiefe mit beiden HA-Fillern bis zu 48 Wochen. <b>Schlussfolgerung:</b> Die einmalige Injektion eines mono- und biphasischen HA-Fillers im randomisierten, doppelblinden Halbseitenvergleich dokumentierte signifikante Verbesserungen mit beiden Präparaten bei allen einbezogenen Parametern bis zu 48 Wochen. Es zeigten sich jedoch signifikante Unterschiede bzgl. Injektionsempfinden, Faltentiefe, ästhetischer Verbesserung und Patientenzufriedenheit, die darauf hinweisen, dass die Behandlung mit dem monophasischen CPMHA-Filler besser toleriert wird.

Neck skin rejuvenation: Histological and clinical changes after combined therapy with a fractional non-ablative laser and stabilized hyaluronic acid-based gel of non-animal origin

Background: The laser Affirm™ (LA) is a microthermal, non-ablative fractional laser used for skin rejuvenation. Restylane Vital™ Light (RVL) in the Restylane® Injector, a formulation of stabilized hyaluronic acid-based gel of non-animal origin, is indicated for rejuvenation of delicate skin. Objectives: To assess the interaction between the LA and RVL in aging skin of the neck using clinical and histological parameters, and to determine whether combined therapy is effective. Methods: Nine female patients aged 42–62 years received four treatments, each comprising RVL followed immediately by LA treatment. Photographs and skin biopsies were taken before treatment, after the fourth session and 1 month later. Results: Improvements in fine wrinkles, tightness and skin texture were observed. Histologic evaluations showed favourable changes in cellularity, collagen and elastic fibres. Laser-induced effects (400 μm) and an inflammatory reaction (1000 μm) were seen. RVL was present at the mid–deep dermis (1000–1500 μm). Conclusions: Combined treatment with the LA and RVL improved skin appearance and structure as assessed, for the first time, with histology. The LA produced epidermal and superficial dermal changes whereas RVL acted deeper, together treating the full skin thickness.

Macrolane™ complications after breast augmentation: treatment and prevention

Macrolane™ (Q-Med AB, Uppsala, Sweden), an injectable preparation of stabilised hyaluronic acid-based gel of non-animal origin (NASHA-based gel), is used for breast augmentation. Here, we describe how our experience of changing injection techniques for NASHA-based gel reduced the rate of complications and increased successful treatment of any remaining complications. A total of 320 patients were treated with NASHA-based gel injected through a single injection site as multiple or single deposits, with or without ultrasonographic guidance. Complications were reduced when injecting the gel into the space between the deep fascia and pectoralis muscle, or in the submuscolar plane or into the pectoralis muscle, using a single injection technique under ultrasonographic guidance. Complications such as lumps were easily treatable with aspiration or hyaluronidase injection. One woman experienced a mild infection, which was resolved using antibiotics. Our clinic’s experience shows that when using our preferred injection technique, complications are reduced for this effective and minimally invasive treatment for breast augmentation.

Injection of Stabilized Hyaluronic Acid-Based Gel of Non-Animal Origin for the Correction of Nasolabial Folds

BACKGROUNDThe use of injectable hyaluronic acid–based gel of non-animal origin, manufactured using the patented NASHA technology, is well established in aesthetic facial procedures.OBJECTIVETo compare injection pain, dermal filler efficacy, and safety of NASHA-based gel with or without 0.3% lidocain

Novel Administration Technique for Large-Particle Stabilized Hyaluronic Acid-Based Gel of Nonanimal Origin in Facial Tissue Augmentation

The use of large-particle stabilized hyaluronic acid-based gel of nonanimal origin (NASHA™) for facial aesthetic procedures is widespread and increasing. A panel of experts with extensive clinical experience with NASHA based gel recently attended an advisory board meeting to develop guidelines for its use in volumetric tissue augmentation.Discussions included details of the blunt-cannula injection technique currently recommended for administration of large-particle NASHA-based gel. With the aim of optimizing patient comfort and control over administration of NASHA-based gel, the panel members explored an alternative,sharp-needle technique. In this article we describe the new technique in detail, together with practical recommendations and precautions. The technique has several advantages over blunt-cannula injection: improved patient comfort, lack of need for a skin incision, increased precision regarding the implant position, and improved control of injection volume. However, the sharp-needle technique requires a high level of skill and a good knowledge of facial anatomy.

Study on stabilized hyaluronic acid-based gel of non-animal origin for the correction of nasolabial folds

To assess the safety and efficacy of hyaluronic acid-based gel of non-animal origin (NASHA gel [Restylane]; Q-Med AB, Uppsala, Sweden)for correcting nasolabial folds in Chinese. Patients with moderate or severe nasolabial fold (Wrinkle Severity Rating Scale, WSRS) were recruited to receive NASHA gel injection ( < 1.5 ml). The patients were followed up for 6 months. The efficacy was assessed by physicians and patients, respectively. Adverse events (AEs) were recorded and laboratory tests were performed before and after operation. 86 patients were treated. 6 months after injection, improved esthetic results was assessed by patients and physicians independently. 52 AEs happened in 32 cases (37.2%). Most of them were local injection reaction and minor, which were recovered spontaneously. No systemic reaction was found. NASHA gel can improve the nasolabial folds. It is very safe and tolerated.

Effects of a three-session skin rejuvenation treatment using stabilized hyaluronic acid-based gel of non-animal origin on skin elasticity: a pilot study

The purpose of this study was to evaluate in vivo the effects of micropuncture injections of stabilized hyaluronic acid-based gel of non-animal origin (NASHATM, Restylane Vital) on skin elasticity, a major aspect of skin ageing. Patients (n = 19) underwent a series of three treatment sessions, spaced 4 weeks apart, with NASHA injected into the lower facial cheeks. Using the suction principle, 12 parameters describing the viscoelastic properties of the skin were assessed, before each treatment session and at follow-up visits 4 and 16 weeks after the last treatment. Treatment with NASHA significantly increased skin firmness and improved its viscoelastic recovery capacities. The most significant differences from baseline were noted at the end of the study. The changes observed in this study may underlie some of the cosmetic improvements noted after treatment with NASHA.

NASHA/Dx Gel (ZuidexTM) for Stress Urinary Incontinence: Results from a Single-Centre Study of 150 Patients

Objective: The aim of this study was to investigate the sub-jective efficacy and tolerability of transurethral injection of a stabilized hyaluronic acid-based gel of non-animal origin/ dextranomer (NASHA^TM/Dx) gel using the Implacer^TM device (Zuidex^TM) as a minimally invasive treatment for stress urinary incontinence (SUI). Patients and Methods: This was a single-centre study of 150 SUI patients treated with NASHA/Dx gel. Treatment efficacy was measured subjectively by patient self-assessment and patients were followed up until they felt that their SUI was under control and did not intend to seek further treatment. Results: Post-treatment follow-up was 6 months to 5.2 years (median: 28 months). Treatment success was achieved in 74% of patients, of whom 9% received re-peat treatment. Nineteen percent underwent subsequent successful surgical intervention; the remaining 7% considered further treatment unnecessary for their symptoms. Minor treatment-related complications occurred in 24% of patients. These included urethritis (13%) and urinary retention (12%). No serious complications were observed. Conclusion: These results demonstrate that NASHA/Dx gel is an effective treatment for SUI and support its use in patients not responding to more conservative therapy.

Endoscopic treatment of vesicoureteral reflux: Current status

Vesicoureteral reflux (VUR) affects around 1% of all children. It carries an increased risk of febrile urinary tract infections (UTIs) and is associated with impaired renal function. Endoscopic treatment with NASHA/Dx gel (dextranomer microspheres in a stabilized hyaluronic acid-based gel of nonanimal origin) is minimally invasive, well tolerated and provides cure rates approaching those of open surgery: ∼90% in several studies. It has also been shown to be effective in a variety of ‘complicated’ cases. Endoscopic treatment is therefore considered preferable to open surgery and long-term antibiotic prophylaxis. Nontreatment of VUR is being discussed as an alternative option, whereby children are treated with antibiotics only when UTIs occur. Considering all the available evidence, however, active intervention with endoscopic treatment remains preferable. A new approach to managing VUR may nevertheless be considered, with treatment decisions based not only on the grade of reflux, but also factors such as age, sex, renal scarring, and bladder dysfunction. Open surgery would be reserved for use only in the ∼10% of children not responding to endoscopic treatment, and patients with refluxing primary megaureter.

Rejuvenating Influence of a Stabilized Hyaluronic Acid–Based Gel of Nonanimal Origin on Facial Skin Aging

Skin changes associated with aging, such as loss of elasticity and turgor, can have a negative psychosocial impact. Current treatment options aimed at restoring elasticity are often ineffective or hampered by a poor risk/benefit ratio. Clinical observations and biophysical measurements were used to assess the effect of middermal placement of stabilized hyaluronic acid-based gel of nonanimal origin (NASHA, Restylane, Vital, Q-Med) on the appearance and elasticity of facial skin. In this pilot study, 19 female patients underwent a series of three treatment sessions, spaced 4 weeks apart, with NASHA injected into the lower cheeks. Elasticity, skin surface roughness, dermal thickness, and density were evaluated at each treatment session and at 4 and 12 weeks after the last treatment session. Patient satisfaction was assessed, and photographs were taken at each visit. During the course of the study, skin elasticity and surface roughness improved significantly. Patient feedback was extremely positive. Micropuncture placement of NASHA can exert a rejuvenating effect on facial skin.