Department of Dermatology, Bravo Private Clinic, Rio de Janeiro, Brazil.
J Cosmet Dermatol. 2024 Oct;23(10):3173-3181. doi: 10.1111/jocd.16393. Epub 2024 May 20.
Nonsurgical cosmetic procedures, particularly the use of hyaluronic acid (HA)-based soft tissue fillers, are becoming increasingly popular. This trend has catalyzed the development of a plethora of HA-based products differing in product characteristics, thereby catering to an ever-widening spectrum of aesthetic applications. However, complications rise concomitant with the increasing number of procedures. Among the strategies to manage such adverse events is the enzymatic breakdown with hyaluronidase.
To analyze the response of different HA-based soft tissue filler materials to hyaluronidase injections.
A total of 11 different HA-based soft tissue fillers were evaluated using noninvasive ultrasound imaging to assess their behavior in response to hyaluronidase injections. The HA-based soft tissue fillers were categorized according to their product characteristics into a structuring, volumizing, and lip volumizing group. Standardized injections of 0.2 cc were performed in chicken breast to simulate human tissue. Ultrasound measurements of width, height, and calculated volume were performed immediately after filler injection, 1 h and 24 h following hyaluronidase injection.
Regardless of the soft tissue filler analyzed, the most significant volume reduction occurred within the first h after applying hyaluronidase, with a 64.1% decrease from the initial volume. After 24 h, the total volume reduction reached 81.7%. No statistically significant differences were found when comparing the three groups at each follow-up time period, except for the height measurement after 1 h. While width was statistically significant in all groups between the investigated follow-up groups, the volume reduction was only statistically significant in the groups with the highest and second highest G' values (i.e., Group 1-structuring, Group 2-volumizing).
The effectiveness of hyaluronidase in dissolving HA-based fillers is initially independent of product characteristics of HA-based fillers such as G-prime, with increased efficacy in fillers with higher G-prime values, as evidenced by significant volume reductions in such groups.
非手术美容程序，特别是使用透明质酸（HA）为基础的软组织填充剂，越来越受欢迎。这种趋势促进了大量 HA 为基础的产品的发展，这些产品在产品特性上有所不同，从而满足了越来越广泛的审美应用。然而，随着手术数量的增加，并发症也随之增加。管理这些不良事件的策略之一是用透明质酸酶进行酶解。
分析不同 HA 为基础的软组织填充材料对透明质酸酶注射的反应。
共评估了 11 种不同的 HA 为基础的软组织填充剂，使用非侵入性超声成像来评估它们对透明质酸酶注射的反应。根据产品特性，将 HA 为基础的软组织填充剂分为结构填充剂、体积填充剂和唇部填充剂。在鸡胸脯上模拟人体组织进行 0.2 cc 的标准化注射。在填充剂注射后立即、注射透明质酸酶后 1 小时和 24 小时进行宽度、高度和计算体积的超声测量。
无论分析哪种软组织填充剂，在应用透明质酸酶后 1 小时内，体积减少最为显著，与初始体积相比减少了 64.1%。24 小时后，总体积减少了 81.7%。除了 1 小时后的高度测量外，在每个随访时间段比较三组时，没有发现统计学上的显著差异。在所有组中，宽度在所有研究的随访组之间均具有统计学意义，而体积减少仅在 G'值最高和第二高的组（即第 1 组-结构填充剂，第 2 组-体积填充剂）中具有统计学意义。
透明质酸酶溶解 HA 为基础的填充剂的效果最初与 HA 为基础的填充剂的产品特性（如 G-prime）无关，随着 G-prime 值较高的填充剂的效果增强，这种效果更为明显，因为这些组的体积减少更为显著。
