Hyaluronic acid (HA) is a remarkably multifaceted biomacromolecule, playing a role in regulating myriad biological processes such as wound healing, tissue regeneration, anti-inflammation, and immunomodulation. Crosslinked high- and low-molecular-weight hyaluronic acid hydrogels achieve higher molar concentrations, display slower degradation, and allow optimal tissue product diffusion, while harnessing the synergistic contribution of different-molecular-weight hyaluronans. A recent innovation in the world of hyaluronic acid synthesis is represented by NAHYCO^® Hybrid Technology, a thermal process leading to hybrid cooperative hyaluronic acid complexes (HCC). This review summarizes the current literature on the in vitro studies and in vivo applications of HCC, from facial and body rejuvenation to future perspectives in skin wound healing, dermatology, and genitourinary pathologies.

The aim of the case series was to determine the efficacy of a new medical device developed for adipose tissue restoration in the face. The medical device used the patented NAHYCO^® Hybrid Technology to deliver 45 mg of high- (1400 ± 200 kDa) and 45 mg of low- (100 ± 20 kDa) molecular-weight hyaluronan, in 2 mL. Patients and methods: Twenty-two volunteers, aged 36–60 years. Two mL of Profhilo^® Structura was injected using a 25 G cannula for each hemiface, into superficial fat compartment along the line from the preauricular area to the mandibular angle. Two injections were performed, and Profhilo Structura’s effect on restoring adipose tissue was evaluated immediately after treatment, and over a 6-month follow-up. The studied medical device revealed a pseudoplastic behavior and consistency that allowed easy extrusion from a syringe. It showed a lower viscosity compared to dermal fillers, based on crosslinked HA. Clinically, the soft tissue thickness increased immediately after injection, and the clinical improvement persisted across a 6-month follow-up. The self-reported satisfaction with the treatment showed an amelioration in the midface of all the subjects enrolled, with no adverse effects. Profhilo^® Structura demonstrated a peculiar fat compartment integration, with a regenerating effect on adipose tissue senescence. The skin thickening and compaction effects were similar to those obtained using chemically crosslinked dermal fillers, while a natural look was preserved, and the use of crosslinking agents was avoided.

Hyaluronic acid (HA)-based dermal fillers are among the most popular non-invasive facial aesthetic treatments. To ensure an effective and safe treatment experience, knowledge of their biophysical and rheological characteristics, such as: HA concentration, molecular weight (MW), G′, and the degree of cross-linking is essential. Products with a higher MW, G′, and degree of cross-linking are more suitable for promoting volume and lift. Dermal fillers with a lower MW, G′, and degree of cross-linking can produce a soft filling effect that regulates hydration and elasticity. This review discusses how these rheological characteristics can inform treatment choice and their effects on clinical outcomes. The Aliaxin^® line of HA dermal fillers, which are tailored to different clinical applications due to their rheological characteristics, highlights that extensive knowledge of the product can provide very safe and effective procedures for patients, whilst respecting their natural facial aesthetics. This review discusses studies using Aliaxin^® dermal fillers for volumizing and hydrating treatments and fillers that can be used for lip augmentation. Treatment with Aliaxin^® was overall very effective, with no reported adverse events. A full facial treatment using tailored dermal fillers may be a future approach to achieve an effective and safe harmonized and natural aesthetic.

This real-world data evaluation assesses the effectiveness of a hyaluronic acid-based product (Profhilo^®, IBSA Farmaceutici Italia, Lodi, Italy) for improving neck skin laxity, firmness, tone, and texture in a satisfaction survey involving 26 patients from Malaysia (n = 9), Singapore (n = 9), and Indonesia (n = 8). Each patient received two treatments: the first at baseline, and the second on Day 30. Using the IBSA Neck Skin Laxity Scale (IBSA NSLS), physicians evaluated photographs of the patients’ necks at baseline, Day 30, and Day 90. Before treatment on Day 30 and at the follow-up visit on Day 90, physicians and patients assessed clinical improvement and satisfaction related to skin laxity, firmness, and texture. After each treatment, the patients recorded their pain level using a visual analogue scale. The mean IBSA NSLS grades for all patients significantly decreased from 3.08 at baseline to 2.12 at follow-up (p < .0001). At Day 90, the most frequent response from all participants was that their neck laxity and skin firmness and tone was either improved or much improved and their skin texture was very much improved. Following the injections, the patients reported low to moderate pain levels. In this real-world satisfaction survey involving patients from Malaysia, Singapore, and Indonesia, the physicians concluded that Profhilo^® was an effective and well tolerated treatment for improving neck skin laxity, firmness, tone, and texture in patients of varying ages, genders, and baseline skin laxity and wrinkle severity.