Affiliation:
1. Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, 01067 Dresden, Germany
2. Faculty of Medicine, Clinic for Dermatology, University Clinical Center, 18104 Nis, Serbia
3. Department of Plastic Surgery, Hospital São Lucas da PUCRS, Porto Alegre 90610-001, Brazil
Abstract
Background: Hyaluronic acid fillers (HAF) are a versatile tool in esthetic medicine. They also have a potential for medical indications including facial rehabilitation. Materials and methods: We performed a literature search on PUBMED and Google Scholar until December 2022. Clinical trials, clinical studies, review articles, systematic reviews, meta-analyses, case series, and case reports were considered for review. Keywords “facial rehabilitation”, “acne scars”, “traumatic scars”, “oral restoration”, “facial lipoatrophy”, “facial asymmetry”, “periocular correction”, “nasal obstruction”, “ear lobe restoration”, “morphea”, AND “hyaluronic acid filler” were used to select articles. Results: We prepared a narrative review on the use of HAF for correction of facial asymmetry and asymmetric lips, improvement of different types of scars, improvement of the jaw line, improvement of ear lobes, periocular and oral restoration, and the treatment of nasal obstruction and morphea en coub de sabre. The amount of HA used in these indications is often less than 1 mL. The bolus technique, fanning, and dual-plane injections can be utilized for treatment. Duration of clinical effects depends upon the anatomical region and is usually maintained between 2 months and 2 years. Adverse events are often mild and temporary. Vascular occlusion is a severe adverse event, but it has not been reported yet for these medical indications. Repeated injections are recommended to obtain a longer-lasting improvement. In cases of morphea, only stable and non-inflammatory plaques should be treated. The advantage of HAF compared to permanent and semipermanent fillers is the availability of hyaluronidase for rapid removal of filler material and to revise overcorrection. Conclusions: HAF play an auxiliary role in facial rehabilitation. Knowledge of filler qualities, anatomy, and underlying diagnoses is important for their safe application. More prospective controlled trials are necessary to improve evidence.
Subject
Dermatology,Pharmaceutical Science,Aging,Chemical Engineering (miscellaneous),Surgery
Reference87 articles.
1. Hyaluronic acid dermal fillers: Safety and efficacy for the treatment of wrinkles, aging skin, body sculpturing and medical conditions;Wollina;Clin. Med. Rev. Ther.,2011
2. Morphological evidences following pegylated filler treatment in human skin;Zerbinati;J. Biol. Regul. Homeost. Agents,2017
3. Fundarò, S.P., Salti, G., Malgapo, D.M.H., and Innocenti, S. (2022). The rheology and physicochemical characteristics of hyaluronic acid fillers: Their clinical implications. Int. J. Mol. Sci., 23.
4. Mechanism of water dynamics in hyaluronic dermal fillers revealed by nuclear magnetic resonance relaxometry;Kruk;Chemphyschem,2019
5. Spreading pattern and tissue response to hyaluronic acid gel injections in the subcutis: Ultrasound videos, ultrasound measurements, and histology;Vandeputte;Aesthetic Surg. J.,2021