Decomposition and Changes in In Vivo Post-HA Filler Injection: A Review.

IF 2.3 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology Pub Date : 2024-10-28 DOI:10.1111/jocd.16652

Gi-Woong Hong, Jovian Wan, Kathleen Chang, Youngjin Park, Kyu-Ho Yi

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引用次数: 0

Abstract

Background: Hyaluronic acid (HA) fillers are widely used in aesthetic medicine, but their in vivo behavior and long-term effects are not fully understood.

Aims: To review the decomposition and changes occurring in the body following HA filler injections, focusing on crosslinking agents, degradation processes, and tissue responses.

Methods: This review analyzed oxidative and enzymatic degradation processes of HA fillers, evaluated the impact of 1,4-Butanediol Diglycidyl Ether (BDDE) crosslinking, and examined histological changes post-injection.

Results: Uncrosslinked HA degrades rapidly due to endogenous hyaluronidase, while crosslinked HA undergoes slower degradation via free radicals and hyaluronidase. Complete cross-linking (C-MoD) showed better durability compared to partially cross-linked BDDE (P-MoD). The concept of modification efficiency (MoE) was proposed to optimize filler safety and viscoelastic properties. Histological analysis revealed collagen capsule formation and autologous tissue replacement, affecting long-term outcomes. The degree of chemical modification (MoD) influences filler durability and safety, with concerns raised about potential delayed immune reactions from accumulated pendent BDDE.

Conclusions: Clinicians should consider injection site, tissue conditions, and filler properties for safe and effective HA filler use. Emphasizing thorough BDDE removal and optimal crosslinking can enhance treatment safety and efficacy. The balance between achieving desired viscoelastic properties and minimizing potential risks is crucial. Future studies should include diverse ethnic groups to validate findings and further explore long-term tissue responses to HA fillers.

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注射 HA 填充剂后体内的分解和变化：综述。

背景：目的：综述注射透明质酸（HA）填充剂后体内发生的分解和变化，重点关注交联剂、降解过程和组织反应：本综述分析了HA填充剂的氧化和酶降解过程，评估了1,4-丁二醇二缩水甘油醚（BDDE）交联的影响，并研究了注射后的组织学变化：结果：未交联的医管局在内源性透明质酸酶的作用下降解迅速，而交联的医管局通过自由基和透明质酸酶降解较慢。与部分交联的 BDDE（P-MoD）相比，完全交联（C-MoD）显示出更好的耐久性。有人提出了改性效率（MoE）的概念，以优化填充物的安全性和粘弹性能。组织学分析表明，胶原囊的形成和自体组织的替代会影响长期疗效。化学修饰程度（MoD）会影响填充剂的耐久性和安全性，累积的悬垂溴化二苯醚（BDDE）可能会引起延迟免疫反应：临床医生应考虑注射部位、组织条件和填充剂特性，以安全有效地使用 HA 填充剂。强调彻底清除 BDDE 和优化交联可提高治疗的安全性和有效性。实现理想的粘弹性和最大限度降低潜在风险之间的平衡至关重要。未来的研究应包括不同的种族群体，以验证研究结果，并进一步探索组织对 HA 填充剂的长期反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cosmetic Dermatology DERMATOLOGY-

CiteScore

4.30

自引率

13.00%

发文量

818

审稿时长

>12 weeks

期刊介绍： The Journal of Cosmetic Dermatology publishes high quality, peer-reviewed articles on all aspects of cosmetic dermatology with the aim to foster the highest standards of patient care in cosmetic dermatology. Published quarterly, the Journal of Cosmetic Dermatology facilitates continuing professional development and provides a forum for the exchange of scientific research and innovative techniques. The scope of coverage includes, but will not be limited to: healthy skin; skin maintenance; ageing skin; photodamage and photoprotection; rejuvenation; biochemistry, endocrinology and neuroimmunology of healthy skin; imaging; skin measurement; quality of life; skin types; sensitive skin; rosacea and acne; sebum; sweat; fat; phlebology; hair conservation, restoration and removal; nails and nail surgery; pigment; psychological and medicolegal issues; retinoids; cosmetic chemistry; dermopharmacy; cosmeceuticals; toiletries; striae; cellulite; cosmetic dermatological surgery; blepharoplasty; liposuction; surgical complications; botulinum; fillers, peels and dermabrasion; local and tumescent anaesthesia; electrosurgery; lasers, including laser physics, laser research and safety, vascular lasers, pigment lasers, hair removal lasers, tattoo removal lasers, resurfacing lasers, dermal remodelling lasers and laser complications.