| PRIME PRoMotIon
was a slightly increased tendency for swelling during the initial phase. There were no subsequent complications. In the author’s view, this substance represents an interesting development in the field of fillers.
Injection technique Varioderm Subdermal was injected in 80% of the patients using 18 and 20 gauge cannulae, and a 26 gauge needle in 20% of patients. The injection technique began with horizontal injections from the edge of the malar bone forward towards the nose and strictly inferior to the orbital rim. It is important to avoid any large boluses; to make the injection easier, the skin must be stretched in the opposite direction to the point of injection (Figure 1).
Clinical trials The latest development of HA-based Varioderm products is a highly cross-linked HA (up to 80% cross linking grade), which has no suspension at all and still has the best injectability profile. Varioderm Subdermal, a newly developed HA-based soft tissue filler from Adoderm, was studied between 2007 and 2010. A total of 108 patients were treated for a range of indications. The product comprises
27 mg/ml of cross-linked
Varioderm Subdermal, which has the highest concentration of dermal filler currently available worldwide.
Injected sites Varioderm Subdermal was injected in subcutaneous soft tissue using a 26 gauge needle and blunt cannula (18 or 20 gauge). Careful injection using the fanning and tunnelling technique is necessary to prevent any irregularities or palpable mass. Subcutaneous injections of Varioderm Subdermal
were mostly used for the treatment of deep nasolabial and marionette folds, cheeks, cheek bones and chin augmentation (Table 1). It is also possible to perform the injection at the supra-periosteal plane. The injection pressure was acceptable and acute reactions such as swelling, reddening and pain were either minimal, or did not occur. A pronounced volume effect and good adaptation to the tissue were observed, so that even very pronounced folds could be augmented. No complications were noticed either in the short-term or during check-ups after 3, 6, 9 and 12 months, with
Figure 1 Injection technique
Table 1. Injected sites Region
Cheeks and malar enhancement
Nasal bridge and tip
Malar and nasolabial fold Tear trough and chin
Number of patients (%)
43 (39.8)
22 (20.4) 41 (37.9) 2 (1.90)
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