SCIENCE-BOOK 29.04.2025 - Flipbook - Page 8
FILLERS
Safety pro昀椀le
Summary of the publication:
04
Safety and Aesthetic Outcomes of Using Fillers
with Different Cross-Linking Agents: A Case Report
Authors: Menkes S. | Published on 02.08.2023
INTRODUCTION
This is the case of a healthy 42-year-old woman who received HA injections
several times starting in 2021.
In 2021, an adverse reaction of unknown origin occurred once after application in
the chin area. After the hyaluronic acid augmentation procedure (HA-BDDE) in the chin
area, there was swelling, which subsided after using Hylase and corticosteroids. A
year later (in 2022), she repeated the procedure, injecting 2 ml of cross-linked BDDE
hyaluronic acid in the zygomatic/malar area. About 3 weeks after injection,
oedema and nodules appeared at the injection site in the zygomatic/malar area. No
disturbing changes were observed in other places except where hyaluronic acid
was administered, and no enlarged adjacent lymph nodes were noticed. The patient
was given Prednisone in decreasing doses, starting with 60 mg orally per day, and the
lesions resolved. In the same year (2022), after discussing the benefits and risks of a new
injection, the patient decided to repeat the treatment, this time choosing hyaluronic
acid cross-linked with PEG.
RESULTS
The patient tolerated the procedures well, with no adverse events related to treatment
(Fig. 1, 2). For the treatment was used (for each side):
Neauvia Stimulate 0.5 ml - lateral lower cheek/parotid area to addressee the
sunken area at the parotid level and pre auricular volume loss, it lifts the
jawline.
Neauvia Stimulate 0.5 ml - submalar to address the sunken area and improve
volume loss in the submalar area.
Neauvia Rheology 0.5 ml to correct the mental curve and give projection
to the chin.
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Fig. 1. Before and after injecting hyaluronic acid
cross-linked with PEG, no adverse events related to
treatment were reported.
Fig. 2. Before and after injecting hyaluronic acid cross-linked
with PEG, no adverse events related to treatment were reported.
KEY MESSAGES
PEGylated HA fillers reduce the local immune response, suggesting not only
that PEG-HA does not carry a significant pro-inflammatory risk effect on PMNs,
but also that it can effectively modulate PMN functions, resulting in antiinflammatory effects.
HA-based hydrogels are generally considered safe and well-tolerated, but
recent evidence increasingly points to emerging safety issues related to their
immune function, including delayed hypersensitivity and granulomatous
reactions.
The last treatment - the application of HA filler (this time cross-linked with PEG,
and not as in the previous two administrations of BDDE) - did not cause any
complications short and long-term.
CONCLUSION
The article describes a case of complications after using a cross-linked HA filler.
It is important to emphasize what happened during the last application of the
HA filler, cross-linked with another cross-linking agent, and how cross-linking
technologies can affect the outcome of the treatment or potential adverse
reactions. In the described case, an important role was played by the ability
of the PEG-crosslinked hydrogel to modulate human immunological functions.
Reference: Menkes, S. 2023. Safety and aesthetic outcomes of using fillers with different cross-linking agents. A case report.
Journal of Applied Cosmetology. 41, 2 (Aug. 2023), 120/125. DOI:https://doi.org/10.56609/jac.v41i2.297.
