Search Results (97)

Various biomaterials are currently employed for dermal biostimulation and filling purposes, with hyaluronic acid (HA)-based fillers among those with the most favorable safety profile, albeit exhibiting a limited biostimulatory effect. This study suggests that hyaluronic acid and succinic acid (SA) can significantly induce beneficial effects on skin cells by targeting key aging hallmarks. Human dermal senescent fibroblasts and aged adipocytes were treated with HA + SA, and various aging characteristics were examined through gene expression analysis and microscopy staining. HA was found to stimulate autophagy gene expression, while SA modulated senescence-gene expression, and the combination of these compounds induced mitophagy in senescent fibroblasts. Additionally, the HA + SA promoted adipogenesis, increased IGF1, and decreased TNFA gene expression in aged adipocytes. Furthermore, the conditioned medium from adipocytes treated with HA + SA upregulated key dermal genes such as COL3A1 and EGF. The findings of this study suggest that HA and SA compounds can be used for the biostimulation of aged skin through the regulation of senescence-associated gene expression and cell communication between dermal fibroblasts and subcutaneous adipocytes. Full article

Minimally invasive cosmetic procedures, such as dermal fillers, botulinum toxin injections, autologous fat grafting, intense pulsed light (IPL) treatments, and platelet-rich plasma (PRP) treatments, are increasingly popular worldwide due to their convenience and aesthetic benefits. While generally considered safe, these procedures can result in rare but serious ophthalmological complications. The most catastrophic adverse events include central retinal artery occlusion and ischemic optic neuropathy, which may lead to irreversible vision loss. Other complications include diplopia, ptosis, dry eye, and orbital cellulitis, with varying degrees of severity and reversibility. Awareness of potential ocular risks, appropriate patient selection, and adherence to safe injection techniques are crucial for preventing complications. This narrative review summarizes the incidence, mechanisms, clinical features, risk factors, diagnostic approaches, and management strategies of ocular complications associated with aesthetic medical procedures. A narrative literature review was conducted, emphasizing data from clinical studies, case series, and expert consensus published between 2015 and 2025. Special attention is given to anatomical danger zones, the pathophysiological pathways of filler embolization, and the roles of hyaluronidase and hyperbaric oxygen therapy in acute management. Although many complications are self-limited or reversible, prompt recognition and intervention are critical to prevent permanent sequelae. The increasing prevalence of these procedures demands enhanced education, informed consent, and interdisciplinary collaboration between aesthetic providers and ophthalmologists. Full article

Poly-L-lactic acid (PLLA) filler, which increases volume and collagen synthesis, is used for skin rejuvenation. Subcutaneous adipose tissue (SAT) contains precursors that differentiate into mature adipocytes that secrete adiponectin, which modulates SAT function and increases adipogenesis. During aging, adiponectin and precursor cell functions decrease, reducing adipogenesis and facial volume. Adiponectin also increases collagen synthesis by stimulating fibroblasts. After hydrogen peroxide treatment to induce senescent adipocytes (3T3-L1) and aged skin, follow-up PLLA treatment increased adipogenesis by stimulating the nuclear factor erythroid-2-related factor 2 (NRF2)/peroxisome proliferator-activated receptor gamma (PPARγ)/CCAAT/enhancer binding protein alpha (C/EBPα) pathway. This resulted in increased adiponectin secretion, which promoted collagen synthesis and mitigated the loss of SAT volume. In the senescent adipocyte, PLLA increased NRF2/PPARγ/C/EBPα, adipogenesis factors (fatty acid binding protein 4, lipoprotein lipase, and cluster of differentiation 36), lipogenesis factors (ATP citrate lyase, acetyl-CoA carboxylase, and fatty acid synthase), adiponectin, and lipid droplet size. Treatment of senescent fibroblasts with conditioned medium from PLLA-treated adipocytes increased collagen1 and 3 and decreased matrix metalloproteinase1 and 3 expressions. Similarly, PLLA increased NRF2/PPARγ/C/EBPα, adipogenesis, and lipogenesis factors in aged mouse SAT. Also, PLLA increased adiponectin and adipocyte numbers without hypertrophy and increased collagen accumulation and dermal thickness. In summary, PLLA increased adipogenesis and adiponectin, which increased the volume of SAT and collagen synthesis, thereby rejuvenating aged skin. Full article

Facial aging is a complex process manifesting as skin hyperpigmentation, textural irregularities, and a diminished elasticity, hydration, and evenness of tone. The escalating demand for minimally invasive aesthetic interventions has driven the development of advanced hydrogel-based injectable formulations. This clinical study assessed the safety and efficacy of Hydragel A1, an injectable hydrogel containing hyaluronic acid (HA), niacinamide, and tranexamic acid (TXA), designed to simultaneously address multiple facets of facial skin aging. A cohort of 49 female participants underwent a series of objective and subjective assessments, including the Global Aesthetic Improvement Scale (GAIS), instrumental measurements (Antera 3D, Chromameter, Cutometer, Dermascan, Corneometer), and standardized photographic documentation at baseline (Day 0) and 14, 28, and 70 days post-treatment. The results demonstrated statistically significant improvements in skin hydration, texture, elasticity, and pigmentation following Hydragel A1 administration. Notably, no serious adverse events or significant injection site reactions were observed, confirming the favorable safety profile of the investigated device. Collectively, these findings underscore the potential of a combined HA, niacinamide, and TXA injectable formulation to provide a comprehensive approach to facial skin rejuvenation, effectively targeting multiple aging-related mechanisms. Full article

Hyaluronic acid (HA) dermal fillers represent a cornerstone of modern esthetic medicine, providing a minimally invasive solution for facial volume restoration and skin rejuvenation. However, the diversity of available products, each utilizing distinct crosslinking technologies, presents a challenge for objective comparison and clinical decision making. This study introduces a scientific framework to evaluate and categorize the physicochemical properties of HA fillers based on two key parameter groups: dynamic parameters (e.g., rheology and gel content) and consistency parameters (e.g., extrusion force, water uptake, and gel particle size). Using standardized methodologies, 23 commercially available fillers from five major manufacturers were analyzed, enabling cross-technology comparisons. The findings reveal how specific crosslinking approaches influence the rheological behavior, handling characteristics, and potential clinical applications. By offering an integrated and reproducible assessment, this work helps practitioners select the most suitable filler for individualized treatment plans and encourages manufacturers to enhance product transparency through harmonized testing protocols. Full article

Biopolymer-based dermal fillers have gained attention in facial aesthetics due to their biocompatibility, gel-forming properties, and capacity to stimulate tissue regeneration. However, evidence regarding their clinical performance remains scattered and inconsistent. This systematic review evaluates the current scientific literature on the effectiveness and safety of injectable biopolymers used in facial aesthetic procedures. A systematic search was conducted in PubMed, MEDLINE, and Embase databases for studies published between 2016 and 2024. Only human studies in English assessing clinical efficacy, safety, adverse events, and patient satisfaction were included. Of the 280 articles initially identified, 9 met the inclusion criteria. The selected studies showed improvements in facial volume and wrinkle reduction with gel-based biopolymers such as poly-L-lactic acid (PLLA), polycaprolactone (PCL), and polymethylmethacrylate (PMMA). Most studies reported high patient satisfaction and a low incidence of serious adverse effects. However, methodological heterogeneity and limited long-term data reduced the strength of the evidence. While injectable biopolymers appear to be effective and generally safe, current evidence is limited and variable. Further multicenter randomized trials with standardized protocols and longer follow-up periods are needed. Clinicians should apply these materials with caution, ensuring individualized treatment planning and careful risk assessment. Full article

Tyre wear particles (TWPs), generated from tyre-road abrasion, are a pervasive and under-regulated environmental pollutant, accounting for a significant share of global microplastic contamination. Recent estimates indicate that 1.3 million metric tons of TWPs are released annually in Europe, dispersing via atmospheric transport, stormwater runoff, and sedimentation to contaminate air, water, and soil. TWPs are composed of synthetic rubber polymers, reinforcing fillers, and chemical additives, including heavy metals such as zinc (Zn) and copper (Cu) and organic compounds like polycyclic aromatic hydrocarbons (PAHs) and N-(1,3-dimethylbutyl)-N′-phenyl-p-phenylenediamine (6PPD). These constituents confer persistence and bioaccumulative potential. While TWP toxicity in aquatic systems is well-documented, its ecological impacts on terrestrial environments, particularly in agricultural soils, remain less understood despite global soil loading rates exceeding 6.1 million metric tons annually. This review synthesizes global research on TWP sources, environmental fate, and ecotoxicological effects, with a focus on soil–plant systems. TWPs have been shown to alter key soil properties, including a 25% reduction in porosity and a 20–35% decrease in organic matter decomposition, disrupt microbial communities (with a 40–60% reduction in nitrogen-fixing bacteria), and induce phytotoxicity through both physical blockage of roots and Zn-induced oxidative stress. Human exposure occurs through inhalation (estimated at 3200 particles per day in urban areas), ingestion, and dermal contact, with epidemiological evidence linking TWPs to increased risks of respiratory, cardiovascular, and developmental disorders. Emerging remediation strategies are critically evaluated across three tiers: (1) source reduction using advanced tyre materials (up to 40% wear reduction in laboratory tests); (2) environmental interception through bioengineered filtration systems (60–80% capture efficiency in pilot trials); and (3) contaminant degradation via novel bioremediation techniques (up to 85% removal in recent studies). Key research gaps remain, including the need for long-term field studies, standardized mitigation protocols, and integrated risk assessments. This review emphasizes the importance of interdisciplinary collaboration in addressing TWP pollution and offers guidance on sustainable solutions to protect ecosystems and public health through science-driven policy recommendations. Full article

Background/Objectives: Calcium hydroxylapatite (CaHA)-based dermal fillers are widely used in esthetic medicine due to their dual volumizing and biostimulatory properties. Despite their rising popularity, comparative clinical outcome data evaluating different CaHA fillers remain limited. This prospective, single-center, unblinded study aimed to establish the effectiveness of the CaHA filler Rennova^® Diamond Intense via comparison to the well-established CaHA filler Radiesse^® in terms of clinical performance, safety, and patient satisfaction. Methods: Thirty patients (28 female, 2 male) underwent a single-session bilateral injection of Rennova^® Diamond Intense (right side) and Radiesse^® (left side) in the lower and medial posterior facial regions. Outcomes evaluated at multiple time points included dermal thickness, skin elasticity, transepidermal water loss, patient-reported outcomes (S-GAIS), physician-assessed outcomes (P-GAIS), and adverse events. Results: Both fillers showed improvements across all parameters. Patient-reported S-GAIS indicated predominantly “improved” outcomes at days 60 and 120, whereas physician assessments (P-GAIS) predominantly indicated “very improved” results at day 120. Ultrasound revealed increases in dermal thickness for both fillers. Similarly, improvements in skin elasticity and decreases in transepidermal water loss were observed bilaterally. Mild, transient adverse events (pain, swelling, redness, bruising) resolved spontaneously within 30 days post injection. Conclusions: Rennova^® Diamond Intense effectively increases dermal thickness, improves skin elasticity, and reduces transepidermal water loss, achieving high patient and physician satisfaction. These findings underscore its safety, versatility, and efficacy for esthetic facial rejuvenation, warranting further long-term evaluation. Full article

This study introduces a novel recombinant humanised collagen (DuCol) developed through codon optimisation and prokaryotic soluble expression, exhibiting exceptional biocompatibility and bioactivity. Structural integrity was confirmed via RP-HPLC, SEM, and CD spectroscopy. In vitro evaluations revealed DuCol’s dose-dependent enhancement of NIH-3T3 fibroblast proliferation, adhesion, and migration. In a D-galactose-induced ageing rat model, subcutaneous implantation of DuCol showcased time-dependent anti-ageing effects. Early-stage intervention (30 days post-injection) markedly upregulated COL1A1 expression through the TGF-β/Smad3 pathway activation, outperforming poly-l-lactic acid (PLLA) in collagen deposition. Histological analysis revealed 23.4% greater dermal thickness in DuCol-treated groups compared to PLLA at 90 days. While PLLA exhibited sustained collagen stimulation beyond 90 days, DuCol exhibited superior early-phase efficacy (p < 0.001) with comparable safety profiles (no inflammatory response observed through 180-day monitoring). The combinatorial PLLA/DuCol (P&C) formulation synergistically enhanced dermal regeneration, achieving a 31.7% thicker collagen matrix than monotherapy groups. These results underscore the potential of DuCol as a novel implantable filler material for skin repair and regeneration. Full article

Background/Objectives: Anatomical knowledge of the arterial supply to the lower face is critical to prevent unnecessary harm to patients seeking cosmetic procedures, particularly lower lip dermal filler injections. Our study sought to characterize the prominent vascular structures of the lower lip: inferior labial (ILA), labiomental (LMA) and mental (MA) arteries. Methods: Forty-eight hemiface specimens from 30 formalin-embalmed donors were utilized in this study. Dissection was performed of the LMA, ILA, and MA to determine their diameter, branching pattern for characterization, and to assess their supply to the lip distally. Results: The ILA (mean diameter, 1.5 ± 0.49 mm) was found to be prevalent in 90% of sampled donors. The LMA (1.2 ± 0.53 mm) was found in 75% of donors. All 48 hemifaces were found to have a MA (1.6 ± 0.51 mm). 88% of ILAs, 43% of LMAs, and 96% of MAs were identified as directly supplying the lower lip. Mean location of the MA as it supplied the lower lip was determined to be (−17 mm, −8.2 mm) and (20 mm, −8.1 mm) in the left and right hemifaces, respectively. F-Test for variance found no significant differences amongst the horizontal (p = 0.82) and vertical distances (p = 0.41) bilaterally. Conclusions: Our findings demonstrate the high variability in vascular supply of the lower lip, suggesting the need for high-resolution ultrasound guidance and the integration of anatomical training within injection courses for the safe injection of dermal fillers. Full article

Recently, various biocompatible and biodegradable materials have garnered significant attention as cosmetic fillers for skin rejuvenation. Among these, poly ε-caprolactone (PCL), poly L-lactic acid (PLLA), poly D,L-lactic acid (PDLLA), and polydioxanone (PDO) microspheres have been developed and commercialized as a dermal filler. However, its irregularly hydrophobic microspheres pose hydration challenges, often causing syringe needle blockages and side effects such as delayed onset nodules and papules after the procedure. In this study, we synthesized a polyethylene glycol-poly D,L-lactic acid (mPEG-PDLLA) copolymer to address the limitations of conventional polymer fillers. Comprehensive characterization of the copolymer was performed using nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, and differential scanning calorimetry. The mPEG-PDLLA copolymers demonstrated a unimodal size distribution of approximately 121 ± 20 nm in an aqueous solution. The in vitro cytotoxicity and collagen genesis of mPEG-PDLLA copolymers were evaluated using human dermal fibroblast cells. In this study, angiogenesis was observed over time in hairless mice injected with mPEG-PDLLA copolymers, confirming its potential role in enhancing collagen synthesis. To assess the inflammatory response, the expression levels of the genes MMP1 and IL-1β were analyzed. Additionally, gene expression levels such as transforming growth factor-β and collagen types I and III were compared with Rejuran^® in animal studies. The newly developed collagen-stimulating PEGylated PDLLA may be a safe and effective option for skin rejuvenation. Full article

Background: The attractiveness of the central area (the so-called mid-face area or middle third) has a strong impact on the observer, and the treatment of aging in this area is therefore considered a key component in facial rejuvenation. A standardized photographic and three-dimensional analysis was conducted in this observational study to determine the outcome of volumetric restoration procedures of the mid-face area with HA injection, providing an objective, repetitive, and reliable evaluation of this facial rejuvenation technique. Methods: In total, 47 patients were treated with two types of HA-based dermal fillers, and calibrated, stereoscopic images of the face were taken with volume reconstruction and analysis software performed before (t0), 45 days after HA implantation (t1), and at the check-up after the end of follow-up (t2). Results: In total, 39 out of 47 patients completed the study, which showed an overall volume restoration of 4.46 ± 1.34 mL at 45 days (t0–t1) after HA implantation, maintaining a value of 1.23 ± 0.68 mL at the end of the 318-day follow-up (t0–t2). Conclusions: The results of this study indicate that rejuvenation of the mid-facial region through volumetric restoration with an HA filler leads to an indirect volumetric effect that is clinically more significant than the actual injected volume and equally long-lasting. Full article

In regard to both natural aging and photoaging caused by UV radiation, a decrease in skin collagen and elastin fibers results in the loss of soft tissue volume. Biodegradable polymer fillers have been used to overcome this problem, but the slow rate of reconstruction and particle agglomeration has limited this approach. The DMSB01 filler, which consists of poly d-l-lactic acid (PDLLA) with a methoxy polyethylene glycol (mPEG) initiator, was created to address this issue. In this study, we assessed the reconstruction and dispersion of the DMSB01 filler in vitro, as well as its effect on collagen expression in rats. DMSB01 showed rapid reconstruction and excellent dispersion stability; gelation occurred within 5 min at 37 °C and remained stable. In an animal model, DMSB01 induced M2 macrophages, Transforming growth factor beta (TGF-β) expression, and significantly increased collagens I and III. Collagen recovery and wrinkle improvement were confirmed by the aging and photoaging models, and hematoxylin and eosin (H&E) staining was used to demonstrate the safety and biodegradability of DMSB01. DMSB01 was effective in terms of inducing collagen production and improving skin aging, and shows promise as an innovative ingredient to overcome the limitations of existing fillers. Full article

Skin aging is a complex and multifactorial process influenced by both intrinsic and extrinsic factors. The periorbital area of the face is particularly susceptible to premature aging signs due to its delicate skin structure, and is a major concern for many individuals. While hyaluronic acid (HA)-based dermal filler products are commonly used for periorbital rejuvenation, novel approaches to effectively locally address the visible signs of aging are available. This study aimed to investigate Innovyal Regenerative Action (IRA), an injectable polynucleotide–HA (PN-HA) regenerative complex designed for periocular prejuvenation. Firstly, PN-HA was compared to other commercially available HA-based dermbooster products (Profhilo^®, Suisselle Cellbooster^® Glow, and NCTF^® 135 HA) in terms of rheological properties, in vitro antioxidant capacity, and total collagen production stimulation in human fibroblasts. Secondly, the clinical effects of the IRA PN-HA complex were evaluated in two case reports (monotherapy for periorbital prejuvenation). It was shown that the PN-HA complex outperformed its comparators in terms of relative rheological behavior (biophysical attributes normalized to polymer contents), intrinsic antioxidant activity (CUPRAC, FRAP, and ORAC assays), as well as total collagen level induction (72-h in vitro dermal fibroblast induction model). Generally, the results of this study provided mechanistic and preliminary clinical insights into the potential benefits of the IRA PN-HA complex for periocular cutaneous treatment. Overall, it was underscored that combining the structural support and regenerative properties of PN with the hydrating and volumizing effects of HA bares tangible potential for multifactorial skin quality enhancement and for periocular prejuvenation in particular. Full article

Lip augmentation has become increasingly popular in aesthetic medicine, driven by advancements in dermal filler technologies and injection techniques. This review provides a comprehensive overview of lip anatomy, age-related changes, and current best practices in lip augmentation using dermal fillers. The complex structure of the lips, including multiple layers of skin, muscle, and mucosa, contributes to their unique appearance and function. Age-related changes, such as volume loss, thinning of the vermilion border, and flattening of the philtrum, significantly impact lip aesthetics. Understanding these changes is crucial for developing effective treatment strategies. The review discusses the importance of tailoring treatments to individual patient needs, considering factors such as ethnic variations in lip structure and cultural preferences. It emphasizes the significance of proper filler selection, with hyaluronic acid-based products being the gold standard due to their biocompatibility and reversibility. Injection techniques, including needle and cannula approaches, are described in detail, with a focus on safety and optimal aesthetic outcomes. Anatomical considerations, particularly the vascular supply to the lips, are highlighted as critical for avoiding complications during filler injections. The review also addresses the evolving approach to lip augmentation, which now focuses on restoring natural contours and addressing age-related changes in the perioral region rather than simply increasing volume. Finally, the importance of managing patient expectations and the potential for future advancements in the field are discussed, including the development of more targeted filler products and refined injection techniques. Full article