The liquid lift: Looking natural without lumps

  1. de Felipe, Iñigo 2
  2. Redondo, Pedro 1
  1. 1 Clínica Universitaria de Navarra
    info

    Clínica Universitaria de Navarra

    Pamplona, España

    ROR https://ror.org/03phm3r45

  2. 2 Clinica Dermatologica de Barcelona, Barcelona, Spain
Revista:
Journal of Cutaneous and Aesthetic Surgery

ISSN: 0974-2077

Año de publicación: 2015

Volumen: 8

Número: 3

Páginas: 134 - 138

Tipo: Artículo

DOI: 10.4103/0974-2077.167267 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Journal of Cutaneous and Aesthetic Surgery

Objetivos de desarrollo sostenible

Resumen

Context: Hyaluronic acid (HA) is the most common filler used to rejuvenate. Today, a three-dimensional approach prevails over previous techniques in which this material was used in specific areas of the face such as the nasolabial fold, the marionette line, and the eye trough giving a strange appearance that does not look natural. Even with a volumizing purpose, the injection of HA can sometimes produce clinically detectable nodules or lumps where the filler is deposited. Aims: To develop a new technique of injecting HA that can provide more natural results and avoid the lumpiness and nodular appearance that sometimes occurs with the injection of HA. To detect whether mixing HA with diluted anesthetic agent modifies its behavior. Settings and Design: Prospective, case control, single-center study on a private clinic setting. Materials and Methods: Eighty six patients were enrolled in this study. All of them had a previous treatment with nondiluted HA using a needle at least a year before. Patients were injected with 8 mL of reticulated HA (RHA) mixed with 6 mL of saline and 2 mL of anesthetic agent. The mixture was administered through a cannula inserted in the face, one at mid-cheek and another at frontal-temporal point of entry. Owing to the lifting effect of this mixture we called this procedure liquid lift (LL). Patients were evaluated 1 month, 6 months, and a year later and asked to compare the LL with previous experiences in terms of natural look, pain, and appearance of nodules. Statistical Analysis Used: Student's t-test. Results: One month after the treatment, 83 out of 86 patients (96.5%) thought LL produced a more natural look than the previous treatment with the needle. Sixty two (72%) considered LL less painful than the previous treatment and only eight (9.3%) could detect lumps or nodules 1 month after LL was performed compared with 46 (53.5%) that described this problem with previous needle injections. The incidence of bruising was also clearly lower (7% with LL vs 17.4% with traditional needle). Conclusions: Injection of diluted HA with saline and anesthetic agents through a cannula all over the face or LL can provide more natural results and less lumps or nodules, and is less painful than traditional treatments involving needle injection of nondiluted HA.

Referencias bibliográficas

  • Brandt, (2008), Clin Interv Aging, Hyaluronic acid gel fillers in the management of facial aging, pp. 153
  • Tran C, Carraux P, Micheels P, Kaya G, Salomon D. In vivo bio-integration of three hyaluronic acid fillers in human skin: A histological study. Dermatology 2014;228:47-54.
  • Carruthers, (2003), Dermatol Surg, A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox) and nonanimal sourced hyaluronic acid (NASHA, Restylane) in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: Treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A, pp. 802
  • Rodrigues-Barata, (2013), J Drugs Dermatol, Undesirable effects after treatment with dermal fillers, pp. e59
  • Rhee, (2014), J Dermatolog Treat, Efficacy and safety of a new monophasic hyaluronic acid filler in the correction of nasolabial folds: A randomized, evaluator-blinded, split-face study, pp. 448
  • Lim, (2014), J Cosmet Laser Ther, Rejuvenation effects of hyaluronic acid injection on nasojugal groove: Prospective randomized split face clinical controlled study, pp. 32
  • Rzany, (2012), Dermatol Surg, Full-face rejuvenation using a range of hyaluronic acid fillers: Efficacy, safety, and patient satisfaction over 6 months, pp. 1153
  • Lupo, (2008), J Drugs Dermatol, Natural look in volume restoration, pp. 833
  • Fisher, (2008), Arch Dermatol, Looking older: Fibroblast collapse and therapeutic implications, pp. 666
  • Shetty, (2014), J Cosmet Dermatol, Under eye infraorbital injection technique: The best value in facial rejuvenation, pp. 79
  • Ramirez, (2001), Aesthetic Plast Surg, Full face rejuvenation in three dimensions: A "face-lifting" for the new millennium, pp. 152
  • Weinkle, (2006), J Eur Acad Dermatol Venereol, Facial assessments: Identifying the suitable pathway to facial rejuvenation, pp. 7
  • Isik, (2012), Aesthetic Plast Surg, Contour restoration of the forehead by lipofilling: Our experience, pp. 761
  • Pavicic, (2013), J Drugs Dermatol, A novel, multistep, combination facial rejuvenation procedure for treatment of the whole face with incobotulinumtoxinA, and two dermal fillers- calcium hydroxylapatite and a monophasic, polydensified hyaluronic acid filler, pp. 978
  • Hamman MS, Goldman MP, Fabi SG. Comparison of two techniques using hyaluronic acid to correct the tear trough deformity J Drugs Dermatol 2012;11:e80-4.
  • Murray, (2005), Dermatol Clin, The evolution of soft tissue fillers in clinical practice, pp. 343
  • Carle, (2014), JAMA Ophthalmol, Cosmetic facial fillers and severe vision loss, pp. 637
  • Kim, (2014), J Clin Neurosci, Panophthalmoplegia and vision loss after cosmetic nasal dorsum injection, pp. 678
  • Alhede, (2014), Pathog Dis, Bacterial biofilm formation and treatment in soft tissue fillers, pp. 339
  • Lee, (2015), J Cosmet Laser Ther, Adverse reactions to injectable soft tissue fillers: Memorable cases and their clinico-pathological overview, pp. 102
  • El-Khalawany, (2015), Ann Diagn Pathol, Dermal filler complications: A clinicopathologic study with a spectrum of histologic reaction patterns, pp. 10
  • Daines, (2013), JAMA Facial Plast Surg, Complications associated with injectable soft-tissue fillers: A 5-year retrospective review, pp. 226
  • Park, (2015), Dermatol Surg, A multicenter, randomized, double-blind clinical study to evaluate the efficacy and safety of PP-501-B in correction of nasolabial folds, pp. 113
  • Hyun, (2015), Clin Exp Dermatol, Efficacy and safety of injection with poly-L-lactic acid compared with hyaluronic acid for correction of nasolabial fold: A randomized, evaluator-blinded, comparative study, pp. 129
  • Thomas, (2014), Indian J Plast Surg, Anatomic and mechanical considerations in restoring volume of the face with use of hyaluronic acid fillers with a novel layered technique, pp. 43
  • Beer, (2014), J Cosmet Dermatol, Remodeling of periorbital, temporal, glabellar, and crow′s feet areas with hyaluronic acid and botulinum toxin, pp. 143
  • Wang, (2007), Arch Dermatol, In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin, pp. 155
  • Rosa, (2012), Am J Dermatopathol, An experimental study of tissue reaction to hyaluronic acid (Restylane) and polymethylmethacrylate (Metacrill) in the mouse, pp. 716
  • Duffy, (2005), Dermatol Surg, Complications of fillers: Overview, pp. 1626
  • Berros, (2013), Plast Reconstr Surg, Hyalurostructure treatment: Superior clinical outcome through a new protocol-a 4-year comparative study of two methods for tear trough treatment, pp. 924e