Hyaluronic Acid Fillers: Long-Lasting Wrinkle Treatment?

Key Findings

The study evaluated DermaLive and DermaDeep, filler implants combining pure hyaluronic acid (produced via cell culture) and acrylic hydrogel, for wrinkle reduction and volume restoration. Key results include:
- 60% resorption rate of the initial material after the first injection, indicating long-lasting effects compared to fully bioresorbable hyaluronic acid fillers.
- Multiple injections (2–3 sessions, spaced ≥3 months) were often required to correct deeper wrinkles or post-scar depressions.
- High tolerance over 3 years, with only 1.2 long-term adverse events per 1,000 patients, primarily presenting as palpable nodules treated with corticosteroid injections.
- Combination therapy with pure hyaluronic acid fillers (e.g., Juvederm, Restylane) for fine lines yielded "safe and excellent aesthetic results."

Study Design

• Type: Observational study (non-randomized, no control group).
• Duration: 3 years of clinical experience (retrospective analysis).
• Geography: Conducted in Germany and France, with data collected post-marketing (Europe, 1998).
• Sample Size: Not explicitly stated; mentions "several studies" but lacks demographic details (age, sex, skin type).
• Methodology: Retrospective review of clinical outcomes and adverse events in patients treated with DermaLive/DermaDeep for skin depressions or volume restoration.

Dosage & Administration

• Formulation: DermaLive/DermaDeep are injectable fillers containing pure hyaluronic acid and acrylic hydrogel.
• Administration: Intradermal injection for correcting natural/acquired skin depressions (e.g., aging, trauma) or creating volume (e.g., lips, cheeks).
• Dosing: No specific hyaluronic acid dosage quantified in the summary; repeat injections (2–3 sessions) were used for optimal correction.
• Intervals: Minimum 3-month gap between injection sessions.

Results & Efficacy

• Resorption: 60% of the initial material resorbed after the first injection, suggesting partial longevity.
• Efficacy: Long-lasting wrinkle reduction and volume restoration achieved, with combination therapy enhancing results for superficial defects.
• Safety: Low adverse event rate (1.2/1,000 patients), mainly delayed nodules (~6 months post-injection).
• Statistical Significance: Not reported in the summary; outcomes appear descriptive rather than hypothesis-driven.

Limitations

1. Observational Design: Lacks randomization, control groups, or blinding, increasing risk of bias.
2. Sample Size Unclear: No specific number of participants or demographic details provided.
3. No Comparative Data: Did not directly compare DermaLive/DermaDeep to other fillers (e.g., collagen or autologous fat).
4. Short-Term Metrics: Resorption rate and efficacy assessed only after the first injection; long-term durability beyond 3 years unexamined.
5. Adverse Event Reporting: Rare side effects (1.2/1,000) may be underreported due to retrospective analysis.

Clinical Relevance

For patients seeking wrinkle reduction or facial volume restoration, DermaLive/DermaDeep may offer a middle ground between fully resorbable and permanent fillers. The 60% resorption rate suggests effects persist longer than traditional hyaluronic acid fillers (e.g., Juvederm), potentially reducing repeat treatments. However, the need for 2–3 sessions and the risk of delayed nodules (1.2/1,000) highlight the importance of medical supervision. Combining these fillers with pure hyaluronic acid products for fine lines could optimize aesthetic outcomes. Clinicians should note the lack of statistical rigor in this study and consider modern randomized trials for stronger evidence.

Source: PubMed (2001)