Skin rejuvenation requires acombination of different treatment modalities, including lasers, intense pulsed light (IPL), radiofrequency, high-intensity focused ultrasound (HIFU), botulinum toxin, and fillers. Acombined approach is considered optimal; however, same-day combination treatments are generally avoided, and laser treatments are usually performed prior to injection of fillers or toxin due to concerns that light-based energy may inactivate or degrade these substances. The aim of this publication is to provide an overview of the literature on the use of combination therapies and the resulting treatment recommendations. The literature review identified numerous studies on combination therapies in which lasers and energy-based devices (EBDs) were applied on the same day as injections of botulinum toxinA. The identified studies consistently reported clinical improvement and no reduction in the efficacy of botulinum toxinA when administered in close temporal proximity, except in the case of fractional radiofrequency microneedling and HIFU.

Dermal filler injection can restore facial volume and improve contour; however, the precise mechanism underlying its lifting effect remains insufficiently characterized. This study explores how targeted filler placement within facial ligamentous structures contributes to mechanical support and contour elevation through anatomic, ultrasonographic, and biomechanical perspectives. Cadaveric dissection and high-frequency ultrasonography were conducted to examine the morphology, orientation, and density of major retaining ligaments, including the zygomatic, mandibular, and platysmal-auricular regions. Observations were correlated with clinical facial dynamics to delineate how sub-SMAS filler deposition affects fibrous anchoring structures. Facial retaining ligaments were identified as collagen- and proteoglycan-rich fibrous condensations providing localized tensile resistance. Age-related attenuation of these structures reduces their capacity to maintain facial suspension. Targeted sub-SMAS filler injection increased local fibrous density and enhanced SMAS tension, thereby transmitting mechanical lift to the skin through ligamentous attachments. Region-specific reinforcement of dense anchoring zones produced efficient contour elevation with minimal filler volume. The lifting effect of filler injection arises from a synergistic mechanism that combines volumetric restoration with biomechanical reinforcement of fibrous anchoring structures. Understanding the regional variability and mechanical behavior of facial ligaments enables anatomy-based, low-volume rejuvenation strategies that preserve natural dynamics. Further clinical and quantitative biomechanical studies are warranted to validate these observations under physiological conditions.

Objective: To critically appraise the safety and efficacy of male genital augmentation and enhancement procedures, and to formulate consensus recommendations for urologists and medical professionals. Methods: A systematic search of the literature published between 2000 and 2025 was conducted. Outcomes of interest focused on penile length and girth changes, complications, and validated patient-reported outcomes. Risk of bias was assessed using Cochrane RoB-2 for randomised controlled trials (RCTs) and the Newcastle–Ottawa Scale (NOS) for non-randomised studies. Evidence was synthesised qualitatively by intervention type. Consensus recommendations were generated through structured group appraisal by the British Association of Urological Surgeons (BAUS) Section of Andrology and Genitourethral Surgery (AGUS), integrating the evidence base with expert opinion, quality assessments, and patient safety considerations. Results: Thirty-six studies ( n = 3748) were included: 12 injectable fillers and 24 surgical. Injectable fillers produced short-term girth gains with mild, transient complications. Surgical procedures demonstrated modest increases in length and girth, though complicated by infection, fibrosis, and/or device removal. Across the eligible evidence, the risk of bias was high, the quality of evidence was low, and expert opinion was consistently low. Conclusion: Evidence quality remains poor, heterogeneous, and methodologically limited. As such, five key recommendations were generated by the BAUS AGUS committee on genital augmentation and enhancement with either injectable fillers or surgical procedures. Level of evidence: 2

Facial fillers are among the most commonly performed procedures in aesthetic surgery practice. Currently, hyaluronic acid-based products (HA) are the most widely used dermal fillers worldwide. Agarose gel (AG), on the other hand, is another filler material with a three-dimensional structure resembling that of the extracellular matrix. This experimental study aims to evaluate and compare the permanence and structural integrity of two different filler materials injected subcutaneously over time. The AG group served as the experimental group, while HA and saline served as the positive and negative controls, respectively. The saline group was included to distinguish true filler persistence from normal tissue resorption. Equal doses of cross-linked HA, saline, and AG were subcutaneously injected into the dorsal regions of male Wilstar albino rats. After the injection, volume measurements were performed via ultrasonography (US) and magnetic resonance imaging (MRI). After repeating volume measurements on days 7, 28, and 63, skin biopsies were taken from the subjects. The presence or absence of capsule formation, the integrity of the capsule, the capsule thickness, the cell count, the number of blood vessels, and the subcutis thickness were examined histologically. Compared to the HA group, the AG group exhibited a significantly higher rate of intact capsule formation (p = 0.029) and a greater number of cells (p < 0.001). MRI and US-based measurements revealed that HA achieved the highest early volumes but resorbed progressively, whereas AG volumes remained relatively stable. The saline group showed complete resorption by day 7, confirming its validity as a negative control. Statistically significant differences were observed between groups at all time points (p < 0.001). AG demonstrated greater structural stability and a more robust cellular response compared to HA. These results suggest that AG may offer a more durable and biologically active alternative to HA in subcutaneous filler applications. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The infraorbital region is one of the most complex and esthetically critical areas of the face. Age-related changes, such as infraorbital groove and infraorbital fat bulging, frequently coexist and vary significantly among individuals. Although hyaluronic acid (HA) filler injection is a common nonsurgical treatment for infraorbital hollows, improper placement, particularly into the infraorbital fat, can result in suboptimal outcomes and complications such as bulging. Clinical evaluation alone is often insufficient to identify anatomical variations beneath the skin. This study aimed to classify infraorbital grooves and fat patterns using ultrasound imaging and to propose practical guidelines that enhance the safety and precision of filler injections in this region. Thirty one patients aged > 40 years underwent ultrasonographic evaluation of the lower eyelid. Based on the relationship among the infraorbital fat, inferior orbital rim, and visible grooves, five anatomical types (A-E) were identified. Each anatomical type reflects different degrees of infraorbital fat descent and groove depth. In Types D and E, infraorbital fat extends to or beyond the orbital rim, increasing the risk of 1 filler misplacement during deep injections. Pre-injection ultrasound evaluation provides critical insights into fat positioning and vascular structures, supporting safer and more individualized injection strategies. The proposed classification offers a clinically useful framework for personalized infraorbital filler treatments. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Age-related volume loss in the temple results in a hollow and aged appearance. Although dermal fillers are commonly used for correction, the proximity of important blood vessels in this area increases the risk of complications. To evaluate the vascular anatomy of the temporal region using microvascular imaging and assess its implications for anatomical planning of filler injection. Microvascular imaging was used to visualize the superficial temporal artery in 62 patients and the deep temporal artery in 56 patients. Arterial depth was measured and analyzed in relation to age, gender, and body mass index. Measurement consistency was assessed using intraclass correlation analysis. Lower-body mass index and younger age correlated with thinner soft tissue. In some cases, the deep temporal artery was 0.3 millimeters from bone, and the superficial temporal artery 1.15 millimeters from skin. Measurements showed excellent interobserver agreement. No other significant associations were found. The authors' findings demonstrate that superficial and deep temporal arteries may run at variable depths, sometimes close to the skin or periosteum. These variations should be considered in planning temple filler injections. Microvascular imaging may assist in visualizing these vessels and identifying higher-risk zones.

Introduction:Modern aesthetic dentistry increasingly integrates techniques from aesthetic medicine to improve the appearance and function of the oral cavity. Growing patient expectations concerning not only health but also the aesthetics of teeth and perioral tissues have led to the development of interdisciplinary treatment methods. Materials and Methods:This article reviews current techniques used in aesthetic medicine, such as botulinum toxin, tissue fillers, and mesotherapy, and their adaptation in dental practice. The use of platelet-rich plasma (PRP) for aesthetic treatment of the face and perioral structures is also discussed. Results and Discussion:Aesthetic dentistry now includes procedures that enhance both teeth and facial soft tissue aesthetics. Botulinum toxin is used to treat gummy smile, bruxism, and muscular asymmetry. Dermal fillers help in contouring facial structures and enhancing lip volume. Mesotherapy and PRP support tissue regeneration and skin quality, also aiding healing after dental procedures.

With age, temple depressions appear due to age-related atrophy of fatty tissue, leading to a prominent cheekbone and lateral rim of the eye socket. Hyaluronic acid fillers have become very popular in the temple area due to their simple procedure and reliable results. The present study was conducted with the aim of determining the effectiveness of filler injection between the superficial and deep temporal fascia and the diameter of superficial temporal arteries for temple enlargement. The international databases PubMed, EMBASE, and Web of Science were searched using keywords aligned with the study objective up to July 2025. All articles were reviewed by two blinded, independent authors. STATA/MP.v17 (College Station, Texas, USA) was used to perform the analyses. Based on the findings of seven included studies, the efficacy of HA filler injection in the STF and DTF area showed an efficacy of 85% (ES: 85%, 95% CI: 81%-91%). According to subgroup meta-analysis, higher efficacy was observed with volume injection of 1.5 mL on each side (ES: 94%, 95% CI: 77%-100%). Subgroup meta-analysis showed that the 18-gauge cannula had the highest effectiveness (ES: 94%, 95% CI: 77%-100%). For temple augmentation, hyaluronic acid filler injection between the superficial and deep temporal fasciae is a highly effective and safe procedure; it is also recommended to inject filler in small volumes and use 18-gauge and 21-gauge cannulas to target the supraperiosteal and supra-deep temporal fascia layers.

Striae distensae (SD) is a common cutaneous condition with an estimated incidence of 56%, associated with rapid skin expansion, hormonal changes, and genetic factors. While traditional treatments (e.g., topical tretinoin, various lasers) exhibit limitations, non-ablative fractional laser (NAFL), injectable fillers, alpha hydroxy acids (AHAs), and combination therapies have emerged as promising modalities, though certain aspects require clarification. This review aims to synthesize current evidence on the pathogenesis and management of SD, with a particular focus on evaluating the recent progress of 1565 nm NAFL to provide guidance for clinical practice and future research. A systematic literature search was conducted across PubMed, Web of Science, and Scopus databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review prioritized randomized controlled trials, meta-analyses, and substantial clinical studies published between 2010 and 2025. Striae distensae (SD) arises from mechanical tension, hormonal imbalance, and inflammation-induced dermal matrix disruption. Efficacious treatments include alpha hydroxy acids, injectable fillers, 1540 nm Er:Glass laser, 532 nm Nd:YAG laser, picosecond lasers, intense pulsed light, and combination therapies (e.g., fractional microneedling/CO2 laser + PRP). 1565 nm NAFL exhibits favorable efficacy, safety, and tolerance, with enhanced outcomes in combinations. The management of SD is evolving towards individualized combination strategies. Fractional microneedling plus PRP and fractional CO2 laser resurfacing with PRP achieve good results in SD rubra and alba, while 1565 nm NAFL represents a significant advance in minimally invasive treatment. Future research should prioritize large-scale studies, standardized assessment methods, and exploration of novel combinations.

Polynucleotides (PN) are innovative polymers that improve skin hydration and elasticity, serving as alternatives to traditional dermal fillers. Medical devices based on PN High Purification Technology (PN HPT) represent a new generation of injectable products designed to restore hydration, elasticity, and overall tissue quality. PN HPT is known for its clinical versatility and excellent tolerability. To assess the real-world performance and safety of Plinest (40 mg/2 mL of PN HPT in a 2 mL pre-filled syringe), a CE-marked class III medical device for skin rejuvenation of the face, neck, and décolleté. This observational clinical data collection involved 66 adult patients, each of whom could receive treatment in up to three areas (face, neck, décolleté). Patients underwent three sessions of intradermal PN HPT injections. A total of 106 questionnaires were collected: 47 for the face, 33 for the neck, and 26 for the décolleté. Performance was evaluated using the Global Clinical Improvement Scale (GCI-S) and Global Aesthetic Improvement Scale (GAIS). Safety was monitored through spontaneous adverse event (AE) reporting. Clinician-reported outcomes showed visible improvement in 100% of facial treatments, with 53.5% rated as "marked" or "excellent." In the neck and décolleté areas, moderate to significant improvements were observed in over 93% and 88% of cases, respectively. Patient satisfaction ranged from 97% to 100%. No serious AEs occurred. PN HPT demonstrated a favorable tolerability and performance profile in real-life aesthetic practice, supporting its role in improving skin quality and reducing signs of aging.

Photoaging is a skin damage process resulting from prolonged ultraviolet (UV) exposure. Poly-l-lactic acid (PLLA), as a common injectable filler in skin esthetics and anti-aging, is reported to be capable of promoting the synthesis of collagen. However, the potential mechanism remains unclear. This study focused on clarifying the potential molecular mechanisms by which PLLA promotes collagen synthesis in UV-induced skin photoaging. Hs68 cells exposed to UVB (30 mJ/cm2) were employed to simulate skin photoaging. PLLA at different concentrations (100-800 μg/mL) was used to treat cells. The expression of c-Jun, c-Fos, ERK, JNK, and p38 mitogen-activated protein kinase (MAPK) was accomplished by the qPCR. The ROS level and the activities of MMP-1 and MMP-13 were assessed by corresponding kits. The AP-1 activity was evaluated by the dual-luciferase reporter system. Inhibition of MAPK was accomplished by transfection of specific inhibitors. PLLA significantly enhanced the cell viability and reduced ROS production in UVB-exposed Hs68 cells. PLLA contributed a lot to counteracting MMPs activation and collagen degradation induced by UVB exposure. Inhibiting the MAPK pathway not only reduced AP-1 activity but also weakened the activities of MMP-1 and MMP-13. Additionally, the pronounced decline in cell viability and collagen production, as well as the excessive ROS and cell damage, could be ameliorated by inhibiting MAPKs. PLLA significantly alleviated the photoaging of Hs68 cells induced by UVB and effectively promoted the production of collagen via the MAPK/AP-1 pathway.

Filler-induced vascular occlusion remains a rare but serious complication in aesthetic medicine, particularly in the lips, where collateral circulation is limited. Polynucleotide (DOT-PN) is a polynucleotide-based medical device primarily characterized by its hydration capacity and viscoelastic properties. When administered intradermally, PN provides structural support to the extracellular matrix (ECM) and contributes to the optimization of the local tissue microenvironment. Such ECM-level modulation may create conditions favorable for tissue stabilization and secondary vascular recovery following ischemic injury. We report a case involving a 41-year-old woman with upper lip necrosis following hyaluronic acid filler injection. Initial treatment with hyaluronidase partially alleviated ischemia but failed to prevent necrosis. Polynucleotide (DOT-PN; a polynucleotide-based medical device; PharmaResearch Co.,Ltd.; Seoul, Republic of Korea)) was administered intradermally in 4 sessions at 8-hour intervals (q8h×4), alongside conservative wound care. Clinical improvement was observed within 36 hours of the first PN injection. The lesion demonstrated progressive improvement in tissue color, epithelial continuity, and surface integrity over a 4-week period, with no scarring or adverse events. Patient-reported satisfaction was rated 9 out of 10, with minimal pain and no functional sequelae during follow-up. Further controlled studies are warranted to define optimal PN dosing intervals, timing of administration, and comparative effectiveness versus other adjunctive treatments for filler-induced ischemic complications.

In this review we present a comprehensive overview of the published literature related to the use of Hybrid Cooperative Complexes (HCCs) of low- and high-molecular-weight hyaluronic acid in aesthetic medicine. HCCs have been developed to overcome the shortcomings of traditional hyaluronic based dermal fillers. Specifically, HCCs deliver both high- and low-molecular-weight hyaluronic acid (HA), maximizing their complementary effects. They are biocompatible and formulated without the addition of foreign agents. Cooperative hydrogen bonds extend their durability and make them more resistant to hyaluronidase compared to high-molecular-weight HA. The rheological properties of HCC formulations allow for easy exertion through the needle and diffusion in the tissue compared to high-molecular-weight HA alone. In vitro studies have shown that HCCs improve vitality of fibroblasts, keratinocytes and adipocytes, and stimulate production of collagen and elastin. Studies on scratched co-cultures of immortalized human keratinocytes and human dermal fibroblasts demonstrated that HCCs accelerate wound closure. Furthermore, HCCs delayed senescence of mesenchymal stromal cells to a greater extent than high-molecular-weight HA or low-molecular-weight HA alone. Clinical studies show a reduction in wrinkle severity, improvement in skin roughness profile and reduction of skin laxity with pronounced improvement in superficial skin hydration lasting up to 6 months. The formulation intended for restoration of fat compartments demonstrated reduction in cheek volume loss and improvement in skin thickness. Subjects report moderate-to-high satisfaction and are likely to recommend the treatment. Limitations of the published studies are also addressed, as well as reported adverse events and published safety data.

Facial aging, marked by soft tissue atrophy, ptosis, and midfacial structural changes, has amplified the role of dermal fillers in modern aesthetic practice. The bilaminar injection technique leverages the distinct rheological properties of high and low G prime hyaluronic acid fillers to enable dual-plane facial rejuvenation-deep structural support and superficial contour refinement. This case series investigates the clinical efficacy and safety of this technique in correcting tear trough deformities. The study was conducted in a single-center institutional aesthetic setting. Five patients (aged 25-60 years) presenting with midface volume loss and tear trough concerns for both the eyes were included following clinical assessment. Randomization and masking were not applied due to the nature of the procedure. A bilaminar approach was adopted: high G prime fillers were injected supraperiosteally to reinforce & augment deep structures, while low G prime fillers were deposited subdermally for fine contouring. All procedures were performed under aseptic conditions using a combination of needle and cannula techniques. Primary outcomes included periorbital volume restoration and contour correction assessed at a 2-week follow-up. Adverse events and patient satisfaction (measured via visual analog scale) were also documented for 3-6 months. All patients exhibited visible improvement in midface volume and tear trough contour, with high satisfaction scores. Transient ecchymosis and edema were the only noted minor side effects. The bilaminar technique offers a precise, anatomically harmonious, and well-tolerated approach to tear trough rejuvenation, establishing itself as a sophisticated tool in advanced facial aesthetics.

Introduction: Polylactic acid can be classified into poly(L-lactic acid) (PLLA) and poly(D,L-lactic acid) (PDLLA) according to their stereoisomeric structures, and both are widely used as dermal fillers for soft tissue augmentation. Although the clinical efficacy of commercially available PLLA- and PDLLA-based fillers has been well established, variations in their physicochemical properties may lead to differences in handling characteristics and clinical performance. A systematic comparison of these properties among different PLA-based fillers remains limited. Materials and Methods: In this study, the physicochemical characteristics of three PDLLA-based fillers (AestheFill, NeoFilera, and Juvelook) and one PLLA-based filler (Sculptra) were evaluated. The analyses included functional group identification, particle morphology and size distribution observation, reconstitution time measurement, osmotic pressure determination, and viscosity assessment. Results: AestheFill and NeoFilera exhibited similar profiles in terms of functional groups, size distribution, osmotic pressure, and viscosity, while NeoFilera and Juvelook showed comparable particle morphologies. Sculptra displayed distinct particle morphology and viscosity, likely attributable to its PLLA composition, yet showed similarities with Juvelook in functional group identification and osmotic pressure. Additionally, the reconstitution times of Sculptra, NeoFilera, and Juvelook were significantly shorter than that of AestheFill. Conclusions: Although the direct correlation between physicochemical characteristics and clinical outcomes warrants further investigation, this comparative analysis provides clinicians with a clearer understanding of the material properties of PLA-based dermal fillers and may assist in the informed selection of appropriate products for individual patients.

Hyaluronic acid (HA) filler injections are widely known to be safe; however, they cause rare and severe complications such as visual loss. No standardized treatment protocol has been established because of the rarity and heterogeneity of these cases. In this study, the aim was to analyze cases of ocular complications related to HA fillers through a meta-analysis to inform the establishment of guidelines. We conducted a systematic review and meta-analysis by searching PubMed/MEDLINE and Embase for eligible studies published between January 2000 and March 2025. Overall, 58 studies involving 232 unique patients were included. The pooled recovery rate of visual acuity was calculated from 13 studies (n = 179), with more than two patients each, and was estimated at 27.3% [95% CI: 18.1-37.3%]. Visual improvement was significantly associated with initial visual acuity and the type of arterial occlusion. The injection sites that were implicated in visual impairment were predominantly located in the nasal area (45.8%). Ptosis (81.2%) and limitation of extraocular movement (75.8%) were common accompanying complications. Cerebral infarction occurred in 35.0% of cases with available neuroimaging. Visual loss caused by HA filler injection is often irreversible, requiring rapid recognition and tailored treatment. Findings from this study, despite the heterogeneity of current treatment approaches, offer the most comprehensive aggregation to date. Additionally, it provides evidence to guide clinical vigilance and procedural safety.

Rationale:The misuse of antibiotics and immunosuppressive agents has led to an increase in the incidence of infections caused by opportunistic pathogens, and even rare microbial infections such as Mycobacterium chelonae (MC) have emerged. Currently, there are very few reported cases of MC infection globally, and clinical experience in treating this disease is limited. This case report focuses on the treatment methods for infections caused by this bacterium, aiming to accumulate experience for clinicians in the diagnosis and treatment of this condition.Patient concerns:This study reports a case of MC infection that occurred following an invasive cosmetic injection treatment. Due to the progression of the condition, medical intervention was required. The patient underwent combined medication and surgical therapy, and the treatment outcomes were subsequently tracked.Diagnoses:Histopathological examination of the skin lesion, fungal culture, and metagenomic detection of the infectious pathogen suggested MC infection.Interventions:The patient underwent excision of the skin lesion, along with intravenous infusion of levofloxacin hydrochloride and sodium chloride injection at a dose of 0.4 g once daily and oral administration of rifampicin capsules at a dose of 0.45 g once daily. Complete lesion resolution was achieved at 1 month postoperatively.Outcomes:At the 1-month postoperative follow-up, the patient’s rash had healed completely.Lessons:This case fills a gap in domestic and international reports of MC infection following cosmetic filler injections. By employing metagenomic next-generation sequencing, the pathogen was rapidly identified within a short timeframe, significantly reducing the diagnostic delay associated with conventional bacterial culture and identification methods. Early radical lesion excision combined with a dual-antibiotic regimen (levofloxacin–rifampin) achieved complete resolution within 1 month, establishing a replicable treatment paradigm for cutaneous MC infections. Further multicenter prospective studies are warranted to optimize surgical margins and antimicrobial treatment duration.

This review explores the efficacy and safety of using needles compared with cannulas for administering dermal fillers. We assessed and compared needles and cannulas based on the accuracy of injection, amount of associated tissue damage, procedural duration, vascular complications, and injection techniques and also highlighted their respective advantages and limitations. Needles facilitate rapid, precise injections and are suitable for shallow, targeted applications; however, because of their sharp points, if not handled with exacting techniques, needles pose a higher risk for misplacement, vascular damage, and tissue trauma. Conversely, because of their blunt tips, cannulas significantly reduce the potential for perforating blood vessels and thus provide a safer alternative for use in areas with a dense vascular network such as the forehead and nasolabial folds. Although requiring a longer procedure time and the creation of an entry point, using cannulas minimizes tissue disruption and is less likely to cause severe vascular complications. This research highlights the importance of choosing the appropriate injection tool based on specific treatment areas, desired outcomes, and inherent risks. Implementing an informed approach when using needles and cannulas can enhance both patient safety and aesthetic results in facial enhancements.

ABSTRACTBackgroundThe rising popularity of injectable soft‐tissue fillers in esthetic medicine is driven by their potential to provide facial rejuvenation through minimally invasive techniques. Hyaluronic acid (HA)‐based fillers exhibit distinct biophysical characteristics, including rheological properties which are critical for their behavior under mechanical stress. This study aims to compare the viscoelastic properties of commercially available crosslinked (CFs) and non‐crosslinked HA fillers (NCFs).MethodsA total of 28 commercially available HA fillers, including both non‐cross‐linked (n = 3) and cross‐linked types (n = 25), were investigated for their rheological properties. Rheological parameters such as storage modulus (G′), loss modulus (G″), loss tangent (tan δ), and complex modulus (G*) were measured over a frequency range of 0.1–10 Hz.ResultsNCFs showed greater variation in G′ with a mean of 3263% [range: 1767–4177] compared to crosslinked fillers with 247.60% [range: 85–720]. The calculated difference between the change in percent of CFs versus NCFs was 3016% (755) for G′ with p < 0.001, whereas it was 926% (498) for G″ with p < 0.001, and it was −154% (25.8) for tan‐delta with p < 0.001, and 966% (147) for G* with p < 0.001.ConclusionsNCFs and CFs exhibit distinct rheological profiles, with NCFs demonstrating a greater change in their initial rheologic properties when exposed to mechanical stress. This specific biophysical behavior (increase in stiffness and viscosity) predisposes NCFs for dermal structural support with the respective subdermal applications, whereas CFs seem to be more suitable for deep soft tissue injections, offering volumization.

Objective. To evaluate structural and functional changes of facial and body skin after Ellagen filler injections. Material and methods. To achieve this objective, we established the following tasks: to measure and evaluate dynamics of key functional parameters of skin (hydration, elasticity, sebum levels and skin redness); to non-invasively assess possible structural skin changes using acoustic density and thickness of dermis and hypodermis; to evaluate dynamics of effects throughout 18 months after treatment. This was a prospective, interventional, single-center, open-label study in a single group of patients. Parameters measured at the study stages were compared with those at the screening stage (1, 3, 6, 12, and 18 months after treatment). Results. The study showed the high efficiency and safety of the poly-L-lactic acid based Ellagen biostimulating implant in correcting age-related skin changes on the face, neck and trunk. The data obtained indicate that therapy with Ellagen contributes to a significant improvement in key biophysical parameters of the skin, such as moisture, elasticity, thickness and density of the dermis and hypodermis. Conclusion. The preservation of positive functional and structural changes in the skin after 18 months of treatment confirms that Ellagen is an effective and promising means for biostimulation of the skin, providing a long-term improvement in its quality and appearance.