Background: The face is the area most exposed to the normal course of skin aging, both intrinsically and extrinsically. The aim of the study was to evaluate the cellular and clinical response of a therapeutic protocol aimed at countering facial skin aging. Materials and Methods: Twenty female patients with facial skin laxity and photodamage underwent combined therapy including mesotherapy using non-cross-linked hyaluronic acid with calcium hydroxyapatite and an infrared energy-based device treatment with subsequent implementation of PEG-cross-linked hyaluronic acid soft tissue fillers. To evaluate the benefits, patients underwent histological, immunological, and biomechanical evaluations before the treatment and at 21 and 150 days after the treatment. Results: The histological results at 21 days and 150 days after the procedure showed an increase in the number of fibroblasts and angiogenesis. As for the immunological aspect, it was shown that the treatment has an immunomodulating action, avoiding the activation of CD4 and CD8 cells. Biomechanical data showed that, at 150 days after treatment, the average changes in skin elasticity increased by 72% and the skin hydration increased by 49%. Conclusions: A combination of an infrared energy-based device treatment with both non-cross-linked hyaluronic acid and novel PEG-cross-linked hyaluronic acid leads to numerous positive cutaneous changes after histological, immunological, and biomechanical evaluations.

The aim of this study was to test the effect of hyaluronic acid cross-linked with polyethylene glycol containing micronized portions of calcium hydroxyapatite (Neauvia Stimulate) on both local tissue and systemic consequences, which are crucial from the perspective of long-term safety, in patients suffering from Hashimoto’s disease. This most common autoimmune disease is a frequently mentioned contraindication to the use of fillers based on hyaluronic acid as well as biostimulants based on calcium hydroxyapatite. Broad-spectrum aspects of histopathology were analyzed to identify key features of inflammatory infiltration before the procedure and 5, 21, and 150 days after the procedure. A statistically significant effect on the reduction of the intensity of the inflammatory infiltration in the tissue in relation to the state before the procedure was demonstrated, combined with a reduction in the occurrence of both antigen-recognizing (CD4) and cytotoxic (CD8) T lymphocytes. With complete statistical certainty, it was demonstrated that the treatment with Neauvia Stimulate had no effect on the levels of these antibodies. All this corresponds with the risk analysis that showed no alarming symptoms during the time of observation. The choice of hyaluronic acid fillers cross-linked with polyethylene glycol should be considered justified and safe in the case of patients suffering from Hashimoto’s disease.

Recently, thanks to the greater discovery of the mechanisms of facial aging, an alternative to invasive plastic surgery has found space with less invasive aesthetic procedures, also based on an increasingly pressing request. We are specifically referring to dermal filler injection into or under the skin which leads to immediate rejuvenation and aesthetic improvements. In this study, we wanted to analyze the results obtained through the use of NEAUVIA Organic Stimulate, particularly with regard to its effectiveness, which is a cross-linked polymeric hydrogel, containing stabilized sodium hyaluronate 26 mg/mL and calcium hydroxyapatite (1%), glycine and L-proline in buffer pyrogen-free water, in its main indication, namely, the temporary correction of congenital and acquired deficiencies of the soft tissues of the face by intradermal injection. Initially, 70 patients were enrolled, but 10 did not complete the study due to non-observance of the investigation rules, so they were excluded from the protocol. The collected data demonstrate an efficient mechanical effect of the pegylated polymeric acid matrix enriched with low concertation of calcium hydroxyapatite and in accordance with other evidence in vitro and in vivo, and the mechanical support of the interstitial connective space improves the homestays of the anatomical layer rebalancing the physiological activity of the dermis cells.

Objective: This study aimed to evaluate the reconstitution and solubility characteristics of two injectable poly L-lactic acid (PLLA) formulations, the next-generation injectable PLLA-LASYNPRO™ and a previous-generation PLLA (PLLA-SCA), through in vitro analysis. Methods: The study, conducted from 20 November to 11 December 2024, involved reconstituting PLLA-LASYNPRO™ in 5 mL saline solution and PLLA-SCA in 8 mL sterile water or saline (as specified in the instructions for use). Reconstitution processes were recorded using a 4K camera, and microscopic and sieve-based analyses were performed at various time points (1–120 min). The study used standardized methods for reconstitution, observation, and sample collection, including a light microscope and micrometric sieves. Results: PLLA-LASYNPRO™ exhibited rapid, uniform reconstitution, resulting in a homogeneous milky-white solution with no foam formation. In contrast, PLLA-SCA showed a two-phase mixture with foam formation, requiring more vigorous shaking. Over time, PLLA-LASYNPRO™ displayed gradual sedimentation, with no foam, while PLLA-SCA showed a progressive increase in foam volume and sedimentation. Microscopic analysis revealed consistent particle morphology, with PLLA-LASYNPRO™ particles being smaller and homogeneous, and PLLA-SCA exhibiting larger, irregular particles prone to aggregation. Sieve analysis showed that PLLA-LASYNPRO™ produced minimal sediment, whereas PLLA-SCA consistently produced sediment on both 71 µm and 200 µm sieves. Conclusions: PLLA-LASYNPRO™ and PLLA-SCA display distinct reconstitution behaviors, with PLLA-LASYNPRO™ showing more consistent characteristics and fewer issues with foam and sedimentation. These differences may impact clinical applications and require consideration in treatment planning.

Striae distensae (SD), or stretch marks, are a common aesthetic concern with limited effective treatment options. This prospective, single-center, open-label study aimed to evaluate the efficacy and safety of 1470 nm non-ablative laser therapy in improving skin texture and reducing SD dimensions. Twenty healthy female volunteers (aged 19–56) with SD of varying stages underwent three laser sessions at three-week intervals. Treatments were delivered using energy densities of 28–35 mJ per point with spot spacing of 0.8–1.2 mm, uniformly delivered over the affected SD lesions. Assessments were performed at baseline, Day 14, Day 35, Day 56–70, and Day 118–132. SD depth and width were measured using high-frequency ultrasound; aesthetic improvement was assessed using the Global Aesthetic Improvement Scale (GAIS), alongside clinical and photographic evaluations. A statistically significant, progressive reduction in SD size was observed: mean depth decreased from 0.34 mm (SD = 0.16) to 0.18 mm (SD = 0.15), and width decreased from 6.58 mm (SD = 2.65) to 4.40 mm (SD = 2.52) by Day 118–132 (p < 0.01 for both). Most participants reported improvement on GAIS at each follow-up. No severe adverse events occurred; only mild, transient erythema and edema were noted. In conclusion, 1470 nm non-ablative laser therapy showed significant efficacy and a favorable safety profile in SD treatment, offering a promising non-invasive option based on fractional thermal stimulation and selective dermal absorption.

Facial volume deficits, providing long-term facial aesthetic enhancement outcomes for the signs of aging and/or facial contouring. Numerous hyaluronic acid (HA) fillers seem to have similar characteristics, although their properties regarding rheology, viscoelasticity, heat resistance are different in many ways. The resistance heat degradation is important when hyaluronic acid fillers and energy-based devices are going to be used sequentially. Our objective was to determine the characteristics of HA gels in terms of heat resistance. Degradation of the gels was measured as a change of surface area of the sample. Five types of HA fillers, chosen from most common products on the market for temporary correction of congenital and acquired soft tissue deficits of the face via intradermal or subcutaneous injection: 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 20mg/ml HA-BDDE, 25 mg/ml HA-BDDE, 28mg/ml HA-PEG were tested in this study. Even though the three dermal fillers contained the same concentration of HA and were cross-linked with the same cross-linking agent, they were produced by different manufacturers using different technologies developed by individual companies. We tested in vitro resistance to heat degradation using Celltibator GT (Medikan Co., LTD, Seoul, Rep. of Korea) and Autoclave (Medotti 22L PRO, Poland). All of the HA fillers samples (0,3 ml) were placed on the petri dishes and put into the autoclave for 10 minutes (temp. 72,4°C). Three of the gels samples (20mg/ml HA-BDDE, 25mg/ml HA-BDDE, 28mg/ml HA-PEG) each 0,3ml were placed into Celltibator for 10 min, temp. 55,2°C degree, centrifugation: 30 RPM. Centrifugation was used to imitate the behaviour of the fillers under the conditions of forces acting on it in the tissue (stress under the influence of facial expressions, exercises, etc.). The temperatures used during this test correspond with commonly used heat-based devices, such as radio-frequency devices (about 45°C), infrared (about 55-65°C) and HiFU (about 70-75°C). Before and after each test pictures of the samples were taken. Heat degradation of the HA samples was measured by comparing (before and after) the changes of the surface area of samples on the petri dishes (on the graph paper). The 28-mg/ml HA-PEG gel filler demonstrated greater resistance to heat versus the 20- mg/ml and 25-mg/ml BDDE gel fillers. The 28-mg/ml HA-PEG, demonstrated in both test (celltibator with/without rotation and autoclave) greater resistance to heat in terms of deformation / thermal degradation and change of surface area. Selection of dermal filler with the right rheological properties is a key factor in achieving a natural-looking long-lasting desired aesthetic outcome. Hyaluronic acid fillers combined with energy-based devices are frequently used sequentially during the same session, however, in some cases it might cause thermal damage of HA. Caution is advised in using IR over recently injected filler (selection of dermal fillers is crucial in this case). Study limitations include use of in vitro model and lack of inflammatory response in an ex-vivo model.