Ge Shealinna, Chung Hye Jin, Weiss Robert A
Maryland Laser, Skin, and Vein Institute, Hunt Valley, Maryland, USA.
Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA.
Lasers Surg Med. 2025 Jan;57(1):96-100. doi: 10.1002/lsm.23863. Epub 2024 Nov 29.
Prior studies have shown that energy-based devices (EBDs) over pre-injected hyaluronic acid (HA) fillers do not significantly affect clinical outcomes. However, the impact of EBDs over newly FDA-approved HA filler for improving skin smoothness is still undetermined.
To evaluate the immediate histologic changes after various popular EBDs are performed over pre-injected, newly FDA-approved intradermal HA filler.
Abdominoplasty skin was injected with HA superficially. Zone 1 was used as untreated control, while the other zones treated with the 755-nm picosecond laser with diffractive lens array, 1064-nm picosecond and 1064-nm Q-switched lasers, radiofrequency with insulated microneedles, volumetric directional thermal impact ultrasound (VDTI), and thermomechanical fractional injury (TMFI) devices.
Histology shows HA in the superficial to mid dermis. Treatment with fractional Q-switched and picosecond lasers showed expected laser-induced optical breakdown in the epidermis and dermis. RF microneedling, VDTI, and TMFI devices caused thermal damage of collagen bundles with dermal dehydration.
No immediate morphological changes to HA were noted following device treatment. However, the effect of heat-generating devices on the molecular integrity of HA fillers, which are composed of HA and water, remains uncertain.
先前的研究表明，能量型设备（EBDs）作用于预先注射的透明质酸（HA）填充剂时，对临床效果没有显著影响。然而，EBDs作用于新获得美国食品药品监督管理局（FDA）批准的用于改善皮肤光滑度的HA填充剂的影响仍未确定。
评估在预先注射的、新获得FDA批准的皮内HA填充剂上使用各种常用EBDs后立即出现的组织学变化。
在腹壁成形术皮肤上浅表注射HA。区域1用作未处理的对照，而其他区域分别用带衍射透镜阵列的755纳米皮秒激光、1064纳米皮秒激光和1064纳米调Q激光、带绝缘微针的射频、容积定向热冲击超声（VDTI）以及热机械分数损伤（TMFI）设备进行处理。
组织学显示HA存在于真皮浅层至中层。调Q和皮秒分数激光治疗显示在表皮和真皮中出现了预期的激光诱导光学击穿。射频微针、VDTI和TMFI设备导致胶原束热损伤并伴有真皮脱水。
设备治疗后未观察到HA有立即的形态学变化。然而，发热设备对由HA和水组成的HA填充剂分子完整性的影响仍不确定。
