Cosmetic surgeons can use relatively low volumes of a 20-mg/mL, smooth, highly cohesive, viscous hyaluronic acid (HA) filler to correct mid-face volume loss, with high rates of patient satisfaction — even at 12 months after injection, according to a newly published study.
“The study findings suggest that, in daily practice, physicians can provide appropriately selected patients with long-lasting, cost-effective correction using small volumes of this HA filler,” the study’s lead author Monique Wilson, M.D., a dermatologist at Cosmetic Laser Dermatology in San Diego, tells Cosmetic Surgery Times. For reference, the pivotal aproval trial used mean injection volume of 6.65 mL, a large and perhaps unrealistic volume in many practices.
Dr. Wilson and colleagues conducted a two-center, retrospective study of 61 adults (including 58 females) being treated for mild to severe facial volume loss. They used an average initial treatment volume of 1.6 mL, and write at 12 months that 42 of 51 patients, or 82%, reported very much or moderate improvement; 84% were satisfied with their results. At one year, 29 patients, or 48%, elected to have touch-up treatments, for which the researchers used an average HA filler volume of 1.4 mL.
There were no significant differences in initial injection volume or likelihood to get touchup treatment among the eight patients who were dissatisfied at 12 months and those who were satisfied.
Most patients reported that they would elect to have the procedure again, at all time points studied (one, three, six and 12 months). Adverse events were mild, and all resolved spontaneously within 14 days. At the two-year follow-up, there were no reports of delayed adverse events. Patients experienced only mild adverse events — all of which resolved on their own within 14 days. The researchers found no reports of delayed adverse events at the study’s two-year follow-up.
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Pivotal Trial Comparison
Researchers in the pivotal approval trial for a smooth, highly cohesive, viscous, 20-mg/mL HA filler used a mean injection volume of 6.65 mL. But to inject such large volumes in daily practice often isn’t realistic, according to the paper.
“While the efficacy, satisfaction and safety results of the pivotal trials examining the 20-mg/mL, smooth, highly cohesive, viscous HA filler were remarkable, it wasn’t always clear how those results would translate to daily clinical practice, where most patients do not need, or cannot afford, large volumes of HA filler,” Dr. Wilson says. “This study sought to bridge the gap between those pivotal trials and what is happening in the office every day. Other information gathered in the study, including need for touch-ups, adverse events, and willingness to undergo the procedure again, lends us evidence with which to better counsel our patients.”
Whether what these researchers found translates to other filler types is unclear, according to Dr. Wilson.
“Our study only examined the 20-mg/mL, smooth, highly cohesive, viscous HA filler which has unique rheological properties that make it particularly well-suited for mid-face volumization. It would be difficult to generalize these findings to all HA fillers; thus, studies examining the efficacy of low-volume correction with other HA fillers are certainly warranted,” she says.
Disclosures: Dr. Wilson reports no relevant disclosures.