PRIME PRoMotIon |
smile treatment with hyaluronic acid
Marina Romagnoli presents the results of a study on non-cross-linked hyaluronic acid biorestructuration treatment to improve the aesthetics and health of lips, without altering their structure.
A
DR MARINA ROMAGNOLI practices Plastic Dermatology at the Biomedical Institute in Genoa, Italy. She graduated from Genoa University specialising in Dermatology and Venereology; 2nd level Master in Plastic Dermatology, Univ. Tor Vergata, Rome, IT; Member of ISPLAD Management Board (Int’l-Italian Society of Plastic Regenerative and Oncologic Dermatology).
Contact information: Inforomagnolimarina@gmail. com
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GREAT DEAL HAS BEEN WRITTEN about the properties of hyaluronic acid (HA) and its importance to healthy skin. In particular, its hygroscopic properties act as a free-radical scavenger and promote
the metabolic processes underlying the production of new collagen fibres.
Biorestructuration versus fillers In aesthetic medicine, HA is one of the most widely used treatments to fill wrinkles, folds, and scars, and for the augmentation of facial volume and other areas of the body (e.g. breasts and buttocks)1
. For these applications,
where fillers are most widely used, HA is modified by means of a process known as cross-linking, which is essential for the longevity of the implant by protecting it from attack by hyaluronidase and free radicals1
.
The molecule has also been used in aesthetic medicine for its chemical and mechanical abilities to restore natural skin conditions by promoting the repair of age-induced damage, and in cases of oxidative stress and moisture-loss caused by illness or medication. In these cases, the infiltration technique used is different; the HA is not cross-linked and the same area is usually treated in multiple sessions, with a frequency that varies from weekly to monthly, depending on the characteristics of the product used. When natural HA is used, the infiltration plane is usually superficial (dermis) and methods such as the picotage, nappage, and serial puncture are used. Filling wrinkles and volume augmentation are not
the target of this treatment; rather the whole surface of the skin can be restored, including the neck and upper chest (‘risky areas’ for fillers), face and the back of the hand. However, any area of the skin can benefit from this treatment. Depending on the country, this method is known as mesotherapy, biorestructuration, and biorevitalisation2
.
The techniques have different aims, but are complementary: the filler acts on the structure and corrects physiognomic defects, while biorestructuration aims to ‘care’ for the skin’s natural condition and,
October 2011 |
prime-journal.com
by reducing oxidative stress, prolongs the filler’s corrective action. Dehydrated, inelastic and atrophic skin can benefit
from biorestructuration, while effects caused by free radicals and skin damage, such as exposure to sunlight and tanning lamps, smoking, and skin diseases can be prevented and corrected.
Lips: ageing and disease With ageing, the tegumentary system undergoes significant changes caused by a reduction in moisture, elasticity and sebaceous secretion that make the skin more prone to attack by external, climatic and pharmacological agents, owing to a reduction in its mechanical and immune defences, vascular reactivity, cellularity and collagen fibres3
. One example of this is the reduction in collagen
fibres caused by physiological conditions such as the menopause (a decrease of one third of the skin’s entire supply in approximately 3 years), or by exposure to sunlight, tanning lamps and smoking4
. As a result, the
labial mucosa appears dehydrated, less elastic and less firm, with reduced definition between the vermillion border and the white lip.
Purpose of the study Given the positive results to the skin obtained in previous studies, and considering the anatomical and functional identity of the mucosa and vermillion border of the lips, the study leads (M Romagnoli and A Gennai) decided to apply the biorestructuration method to this area, and evaluate its safety and efficacy. In our personal experience, the biggest problem was the pain associated with the treatment and the potential appearance of ecchymoses as a result of needle trauma. Consequently, it was decided to use a 27-gauge flexible, blunt cannula to administer the treatment, rather than a needle.
Safety profile No delayed intolerance reactions such as granuloma, abscesses, hardening of the infiltration area, pruritus
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