What are the lifting effects of dermal fillers, specifically the hyaluronic acid (HA) fillers, in facial rejuvenation?

From the Guidelines

Dermal fillers can provide significant lifting effects, particularly when combining autologous platelet concentrates with cross-linking agents, which can enhance their degradation properties and provide a more natural and cost-effective alternative to traditional fillers. The use of dermal fillers for lifting effects has been supported by recent studies, including an RCT by Hersant et al., which found that combining PRP and HA led to a highly significant improvement in facial appearance and skin elasticity compared with PRP or HA alone 1. Key benefits of using dermal fillers for lifting effects include:

• Providing structural support and restoring volume to key facial areas, such as the midface, cheekbones, jawline, and temples
• Stimulating collagen production, which can enhance their lifting capacity over time
• Offering a more natural and cost-effective alternative to traditional fillers, with the potential for reduced adverse effects and complications
• Allowing for customization of treatment to individual patient needs and facial anatomy. The procedure for dermal filler placement typically takes 30-60 minutes, with minimal downtime, although patients may experience temporary swelling and bruising for 3-7 days 1. For optimal results, treatment should be performed by an experienced injector who understands facial anatomy and can create natural-looking volume restoration rather than overfilling, which can create an unnatural appearance. Overall, the use of dermal fillers, particularly those combining autologous platelet concentrates with cross-linking agents, can provide significant lifting effects and improve facial appearance, making them a valuable treatment option for patients seeking to restore a more youthful and natural-looking appearance 1.

From the FDA Drug Label

12 CLINICAL PHARMACOLOGY

1. 1 Mechanism of Action Hyaluronic acid is also present in the capsules of type A and C hemolytic streptococci. Hyaluronidase hydrolyzes hyaluronic acid by splitting the glucosaminidic bond between C1 of an N-acetylglucosamine moiety and C4 of a glucuronic acid moiety This temporarily decreases the viscosity of the cellular cement and promotes dispersion of injected fluids or of localized transudates or exudates, thus facilitating their absorption.

The lifting effects of dermal fillers, such as hyaluronic acid, are not directly addressed in the provided drug label. The label discusses the mechanism of action of hyaluronidase, which breaks down hyaluronic acid, but does not provide information on the lifting effects of dermal fillers.

• Key points:
  • Hyaluronic acid is a component of dermal fillers.
  • Hyaluronidase breaks down hyaluronic acid.
  • The label does not discuss the lifting effects of dermal fillers. 2

From the Research

Lifting Effects of Dermal Fillers

• Dermal fillers, such as hyaluronic acid fillers, are commonly used for facial rejuvenation and enhancement of facial features 3.
• These fillers can be used to rejuvenate the upper face, and their use in combination with botulinum toxin injections can be effective for this purpose 4.
• Hyaluronic acid fillers are also used for midface augmentation, and studies have shown that they can provide long-lasting effects with high patient satisfaction 5.
• The lifting effects of dermal fillers can be enhanced when used in combination with other nonsurgical procedures, such as chemical peels and botulinum toxin injections 6.
• The selection of the appropriate dermal filler depends on its rheological properties, and understanding these properties can help physicians achieve more predictable and sustainable results 7.

Types of Dermal Fillers

• Hyaluronic acid fillers, such as Juvederm and Restylane, are the most commonly used fillers for soft-tissue augmentation 3, 5.
• These fillers come in different formulations, and their properties can vary depending on their intended use 5, 7.
• The choice of filler depends on the individual patient's needs and the area of the face being treated 3, 7.

Administration Techniques

• The administration technique for dermal fillers can affect their lifting effects, and proper technique is essential for achieving optimal results 4, 5.
• The depth of injection, as well as the location and amount of filler used, can impact the lifting effects of the filler 5, 7.
• Physicians should be knowledgeable about the different administration techniques and select the most appropriate one for each patient 4, 7.