WHAT IS HYALURONIC ACID?

hyaluronic acid is a disaccharide present in all human connective tissues, including the skin. This molecule is essential for the formation of the collagen matrix and elastic fibers and for the maintenance of skin hydration. The alterations of hyaluronic acid present in the skin contribute, over time, to skin aging. hyaluronic acidit exists naturally in all living organisms and is a universal component of the spaces between the cells of the body’s tissues (extracellular space). It is a molecule that has an identical chemical structure whether it is found in bacteria, animals or humans. Being therefore chemically identical in all species and in all types of tissue, hyaluronic acid has a total biocompatibility. The use of hyaluronic acid is well documented not only in medicine and cosmetic surgery but also in other areas of medicine such as ophthalmic surgery and orthopedics. Over the past twenty years, more than 30 million people have been successfully treated with hyaluronic acid products.

HOW MANY TYPES OF HYALURONIC ACID ARE THERE?

The hyaluronic acid used in aesthetic medicine is the result of complex laboratory syntheses obtained with the aid of biotechnology. There are 2 large families of hyaluronic acid: 1) Hyaluronic acid of avian origin (Hylaform type) 2) Hyaluronic acid of bacterial origin Streptococcus equi also called NASHA (Non-Animal Stabilized Hyaluronic Acid) (type Restylane or Juvederm) The hyaluronic acid used in aesthetic medicine it is a sterile, viscoelastic, colorless and transparent gel composed of crossed molecules of hyaluronate. The best quality and duration of hyaluronic acid reabsorption times depend on the quantity of hyaluronate molecules and the intermolecular bonds present in 1 ml of product.

FOR WHAT AESTHETIC DEFECTS IS HYALURONIC ACID USED?

The infiltration based on hyaluronic acid  are indicated for the correction of: Lips: fullness and firmness and vermilion border. Volume and contour of the lips. Creases (e.g. nasolabial). Remodeling of the face contour (e.g. cheeks and chin). Wrinkles (e.g. glabellar and oral commissures). Periocular wrinkles (“crow’s feet”). Post-acne scarring. Post-traumatic scarring. Soft tissue imperfections. Breast and body remodeling. Rhinoplasty outcomes.

HOW IS HYALURONIC ACID USED IN AESTHETIC MEDICINE?

Hyaluronic acid is injected in very small doses into the regions concerned by means of a syringe equipped with a very fine needle.

CAN THE TREATMENT BE CARRIED OUT IN THE AMBULATORY?

Yes. Hyaluronic acid injections are performed in the clinic and the treatment lasts 15-30 minutes. Generally, local anesthesia is not necessary, but sometimes an anesthetic ointment can be used especially for the treatment of more annoying areas such as the lips. Only in the case of treatment with long-reabsorption fillers such as Restylane Sub Q used for the treatment of the chin or cheekbone region, is it advisable to have a local or truncular anesthesia.

HOW LONG DOES THE HYALURONIC ACID-BASED TREATMENT LAST?

L ‘ hyaluronic acid is a resorbable product that may have a duration ranging from 2 months to 1-2 years. The main products on the market can be classified according to the different resorption times in the following categories: Fast reabsorption fillers 2-3 months; Medium resorption fillers 5-6 months; Slow reabsorption fillers 1-2 years.

All the most important and certified pharmaceutical companies have products that have the aforementioned resorption times. The main hyaluronic acid-based fillers for aesthetic medicine are:

Juvederm Hydrate, Juvederm ultra 2, Juvederm ultra 3, Juvederm ultra 4, Juvederm smile, Juvederm Voluma, Juvederm Volift, Juvederm Volbella and the brand new Volite from the American company Allergan.

Belotero Hydro, Belotero Soft, Belotero Balance, Belotero Intense, Belotero Volume of the German company Merz.

Restylane, RestylaneLyft, Restylane Fynesse, Restylane Refyne, Restylane SubQ, Restylane Volyme, Restylane Lips, Restylane Defyne, Restylane Kysse, Restylane Vital and Vital Light of the Swedish company Galderma.

IS THE AESTHETIC RESULT PERMANENT?

Hyaluronic acid is not a permanent filler. This means that once injected, the product is progressively metabolized and then reabsorbed by the body with variable times depending on the area treated and the type of preparation used. The effect of filling and increase in volume or attenuation of wrinkles is immediate and lasts from 2 to 12 months, after which it is possible to repeat the treatment periodically.

WHAT IS MACROLANE?

Macrolane is a new hyaluronic acid with very slow reabsorption, about 2 years, produced by the Swedish pharmaceutical company Galderma, indicated for body remodeling and the correction of retracting cicatricial results.

DOES THE TREATMENT WITH HYALURONIC ACID INJECTIONS LEAVE SIGNIFICANT POSTUMES?

No, since it is a natural substance, hyaluronic acid has no particular contraindications. In the first 24-48 hours after the hyaluronic acid treatment, a slight redness may appear and the treated area may be slightly swollen compared to the result you want to achieve. A small bruise may rarely occur in the injection area. After a few hours it is still possible to cover the area that has been treated with makeup or lipstick.

HYALURONIC ACID: COSTS

Hyaluronic acid has cost very variabil i because it depends on the quality of the product and the quantity that is used. Normally 1 cc of hyaluronic acid of the best brands in the world has a cost that varies from 350 € to 500  € .
The patient must always obtain the coupon of the product that has been used in order to have a guarantee on the quality of the filler.

FAQ HYALURONIC ACID

  1. I have a very thin upper lip and would like advice on the most suitable techniques and on the safest materials to increase the volume of the lips.
    A. The increase in lip volume can be achieved through various medical and / or surgical procedures which consist in the use of injectable filling materials (fillers), solid implants (threads), tissue grafts or local flaps. The choice of the type of procedure (medical or surgical) and of the material that can be used depends on the aesthetic result to be achieved and on the tolerability or otherwise of the products used. The filling materials can be resorbable, semi-permanent or permanent. Absorbable fillers such as collagen and hyaluronic acid have the advantage of being easily tolerated by the body but give a temporary increase in volume (from 4 to 12 months). Semi-permanent fillers have the advantage of giving a more lasting aesthetic result (from 12 to 36 months) but, albeit rarely, they can provoke foreign body reactions (granulomas). Permanent fillers, such as silicone, have the advantage of giving a definitive aesthetic result but sometimes they can give an unpredictable and difficultly controllable and correctable rejection reaction. In my opinion, however, the use of resorbable fillers is always preferable because they allow the patient to decide whether to continue treatment or return to his natural condition and do not cause any side effects.
  2. What causes facial wrinkles and creases?
    A. The skin is made up of layers of cells fed by blood vessels and supported by proteins, including collagen and water. With age the levels of hydration and collagen decrease, the skin sags and wrinkles and wrinkles appear. Even prolonged exposure to sunlight damages the skin and can seriously affect the condition of the skin cells.
  3. What is the most suitable treatment to eliminate or reduce facial wrinkles?
    A. Facial wrinkles can be effectively improved or eliminated through various aesthetic medicine treatments (such as peelings, fillers, dermabrasion, laser, lipofilling and botulinum toxin) or, in the case of particularly deep wrinkles, through cosmetic surgery (lifting) . Peelings: Peelings are chemical solutions that allow you to improve and smooth the skin of the face by removing the most superficial layers damaged by the effects of aging (wrinkles, loss of elasticity and firmness of the skin, etc.). Fillers: Fillers are filling materials that are injected with fine needles into wrinkles. The filling materials can be resorbable, semi-permanent or permanent. Dermabrasion: Dermabrasion is a treatment that allows you to improve the scars and the less deep wrinkles of the face by eliminating the most superficial layer of the skin and giving it a smoother and more regular appearance. Lasers: The lasers that are used for the treatment of wrinkles are the so-called “resurfacing” lasers. Among these, the most effective are the CO2 laser, particularly indicated for periolar wrinkles (around the mouth) and the Herbium laser, more indicated for periocular wrinkles (around the eye or crow’s feet). Lipofilling: The lipofilling technique consists in withdraw small quantities of fat from one part of the body which are then injected into wrinkles by means of a syringe equipped with a thin needle. This treatment is particularly suitable for wrinkles in the zygomatic-ocular region. Botulinum toxin: Botulinum toxin is a drug that temporarily inhibits the action of the facial mimic muscles by reducing the formation of expression lines. Lifting: The lifting is a cosmetic surgery that allows you to eliminate deeper wrinkles and excess fat, repositioning the muscles of the face and relaxing the skin of the face and neck. The best treatment of facial wrinkles is generally given by a correct combination of the remedies illustrated above. repositioning the muscles of the face and relaxing the skin of the face and neck. The best treatment of facial wrinkles is generally given by a correct combination of the remedies illustrated above. repositioning the muscles of the face and relaxing the skin of the face and neck. The best treatment of facial wrinkles is generally given by a correct combination of the remedies illustrated above.
  4. What are fillers and how do they act on wrinkles?
    A. Fillers are filling materials that are injected into wrinkles to fill deficiencies of subcutaneous tissue. Fillers can be resorbable, semi-permanent or permanent. The resorbable fillers have the advantage of being easily tolerated by the body but give a temporary increase in volume (from 4 to 12 months). There are essentially two reabsorbable materials: collagen and hyaluronic acid. Hyaluronic acid is a very popular product with very beautiful aesthetic results. Collage as a filler is no longer used today. Semi-permanent fillers have the advantage of giving a more lasting aesthetic result (from 12 to 36 months) but, albeit rarely, they can provoke foreign body reactions. Permanent fillers have the advantage of giving a definitive aesthetic result but sometimes they can give an unpredictable and difficultly controllable and correctable rejection reaction. Silicone in the form of an injectable gel is a permanent filler the use of which was prohibited by Italian law in the early 1990s due to the numerous side effects it can give rise to. Currently the most common products allowed on the market are: “Bioalcamid” and “Aquamid”. I personally prefer to use resorbable fillers because they allow the patient to decide whether to continue treatment or return to his natural condition and do not cause any side effects. Silicone in the form of an injectable gel is a permanent filler the use of which was prohibited by Italian law in the early 1990s due to the numerous side effects it can give rise to. Currently the most common products allowed on the market are: “Bioalcamid” and “Aquamid”. I personally prefer to use resorbable fillers because they allow the patient to decide whether to continue treatment or return to his natural condition and do not cause any side effects. Silicone in the form of an injectable gel is a permanent filler the use of which was prohibited by Italian law in the early 1990s due to the numerous side effects it can give rise to. Currently the most common products allowed on the market are: “Bioalcamid” and “Aquamid”. I personally prefer to use resorbable fillers because they allow the patient to decide whether to continue treatment or return to his natural condition and do not cause any side effects.

 

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