Efficient treatment of upper-lip rhytidosis by pneumatic administration of hyaluronic acid

García, Pablo Naranjo; Vinshtok, Yuri; Andrino, Rodolfo; Cohen, Naama

doi:10.1080/14764172.2019.1660792

Cited by 5 publications

(10 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A growing, but unregulated grey area, is the jet injection of hyaluronic acid for skin rejuvenation by non‐physicians. Other, more specialized indications are the delivery of bleomycin in common warts, anaesthetics for local pain management, botulinum toxin for hyperhidrosis, and 5‐aminolevulinic acid for photodynamic therapy 10–15 . Jet injectors can also be directed to target the subcutaneous tissue, for example, for administration of biologicals, vaccines, insulin, and nicotine 16–19 .…”

Section: Discussionmentioning

confidence: 99%

Clinical endpoints of needle‐free jet injector treatment: An in depth understanding of immediate skin responses

et al. 2022

View full text Add to dashboard Cite

Objectives: Needle-free jet injectors have been used in dermatological practice for many years. However, predefined clinical endpoints that guide physicians to choose optimal device settings have not been clearly defined. Here, we evaluate immediate skin responses as clinical endpoints for needle-free jet injector treatments. Methods: We injected methylene blue in ex vivo human skin using an electronically-controllable pneumatic injector (EPI; 3-6 bar, 50-130 µl; n = 63), and a spring-loaded jet injector (SLI) with fixed settings (100 µl; n = 9). We measured the immediate skin papule (3D-camera), residual surface fluid (pipette), dermal dye distribution by estimating depth and width, and subcutaneous dye deposition. Results: EPI with 4 bar and 100 µl resulted in the largest skin papule of 48.7 mm 3 (35.4-62.6 mm 3 ) and widest dermal distribution of 8.0 mm (5.5-9.0 mm) compared to EPI with 6 bar and 100 µl (p < 0.001, p = 0.018, respectively). The skin papule volume showed a significant moderate to high positive correlation with the width and depth of dye distribution in the dermis (r s = 0.63, r s = 0.58, respectively; p < 0.001 for both correlations). SLI showed high variability for all outcome measures. Finally, a trend was observed that a small skin papule (≤7 mm) and little residual surface fluid (≤10% of injection volume) were warning signs for subcutaneous deposition. Conclusions: The immediate skin papule and residual surface fluid correspond with dermal drug deposition and are relevant clinical endpoints for needle-free jet injector treatments in dermatological practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical endpoints of needle‐free jet injector treatment: An in depth understanding of immediate skin responses

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The mechanical tension converts dermal fibroblasts into myofibroblasts by the induction of mechano‐responsive genes, accelerates fibroblast proliferation, and inhibits apoptosis 17 . It has been demonstrated that jet‐injected CL‐HA activates synthesis of new collagen type I and III up to 4 months after injection into the skin 10,18 with beneficial effects on facial wrinkles 10,19‐21 and acne scars 9,22 …”

Section: Discussionmentioning

confidence: 99%

High‐velocity pneumatic injection of non‐crosslinked hyaluronic acid for skin regeneration and scar remodeling: A retrospective analysis of 115 patients

MacGillis

Vinshtok²

2021

J of Cosmetic Dermatology

Self Cite

View full text Add to dashboard Cite

Background Pneumatic‐assisted high velocity jet injections are an alternative method for intradermal delivery of hyaluronic acid (HA) and demonstrated efficacy in dermal thickening and scar remodeling with minimal side effects. Aims We aimed to investigate the clinical efficacy comparing non‐crosslinked HA (NCL‐HA) and crosslinked HA (CL‐HA) for aesthetic skin concerns. Methods We retrospectively analyzed charts of 115 patients treated with jet injected NCL‐HA and CL‐HA for skin rejuvenation, age‐related laxity and rhytidosis, hypertrophic and acne scars and striae. Global Aesthetic Improvement Scale (GAIS) and the 5‐grade patient satisfaction scale were used for assessment of the treatment efficacy at the 3‐month follow‐up. Efficacy was separately analyzed between patients receiving NCL‐HA vs. CL‐HA. Longevity of treatment effect was measured by the time to voluntary return for repeat treatment. Results An average of 2.8 treatments was completed per patient with a low incidence of side effects including bruises (7%) and temporary local edema (1%). Patients were highly‐satisfied with the treatment results in all categories with the average satisfaction scores of 3.68 (NCL‐HA) and 3.76 (CL‐HA). An average GAIS score of 1.7 (“much improved”) was calculated for neck, décolleté and perioral areas. An overall GAIS score averaged as 1.78 (NCL‐HA) and 1.6 (CL‐HA). Longevity of the effect averaged 13.1 months for NCL‐HA and 13.2 months for CL‐HA groups. Conclusion Our retrospective data showed similar significant improvement of all aesthetic skin concerns in 115 subjects treated with either NCL‐HA or CL‐HA delivered intradermally by a high velocity jet‐injector device with minimal downtime, pain or side‐effects.

show abstract

“…The “true” clinical effect is determined by the generated tissue micro‐trauma and activated synthesis of ECM components. Although published data rarely report the treatment results beyond the 6‐month efficacy, 26,28,30,32,33 Levenberg 27 demonstrated improvement in Fitzpatrick‐Goldman wrinkle scale up to 18 months which was explained by continuous reorganization of the collagen during the final phase of the wound healing process.…”

Section: Longevity Of Effectmentioning

confidence: 99%

“…The triggered injury‐healing process promotes the neocollagenesis which is thought to gradually replace the initial HA hydration effect 25 . Progressive reduction of rhytidosis and improved turgor and elasticity 26‐28 can be observed as a new collagen continues to be accumulated for approximately 3‐6 months after the treatment 29 (Figure 5). Under higher injection pressure, HA micro‐droplets can be dispersed into deeper layers and generates a volume‐generated tension on fibro‐septal system (retinacula cutis) and superficial musculo‐aponeurotic system.…”

Section: Clinical Effectsmentioning

confidence: 99%

See 1 more Smart Citation

Biochemical and physical actions of hyaluronic acid delivered by intradermal jet injection route

Vinshtok¹,

Cassuto

2020

J of Cosmetic Dermatology

Self Cite

View full text Add to dashboard Cite

Administration of exogenous hyaluronic acid (HA) by liquid jet injection is considered as a beneficial therapy for dermatology conditions. This paper reviews variety of the factors which would optimize the clinical output of hyaluronic acid in this treatment modality. A pneumatically accelerated jet penetrates the epidermis and spherically spreads micro‐droplets of HA in the dermis without significant damage to the tissue and blood vessels. Kinetic energy of the jet activates two parallel mechanisms of action—mechanical and biological—which act synergistically to initiate and augment the regenerative effect. Jet‐induced micro‐trauma stimulates collagen synthesis and tissue repair without inflammation. Aside from the biophysical stimulation of dermal fibroblast, the biomolecular properties of exogenous HA provide excellent clinical results for skin atrophy, remodeling of dermal scarring, and reverse formation of fibrotic tissue. The effect is mediated by HA‐specific cell receptors and depends on molecular weight and the rheological properties of HA polymer. Skin mechanical properties play a key role in predicting HA dispersion patterns. Tolerability and safety of the treatment approach are determined by the jet's physical impact on the tissue and/or by the safety profile of the injected material. Although pneumatic jet delivery of a hyaluronic acid has a limited use in clinical practice, this treatment approach has a strong potential for extended implementation in esthetic dermatology. The synergistic mechanism has significant advantages of predictable and rapid clinical outcomes with a low discomfort. Additional well‐designed investigations are required for establishing a scientific foundation and guidelines for this treatment modality.

show abstract

Efficient treatment of upper-lip rhytidosis by pneumatic administration of hyaluronic acid

Cited by 5 publications

References 2 publications

Clinical endpoints of needle‐free jet injector treatment: An in depth understanding of immediate skin responses

Clinical endpoints of needle‐free jet injector treatment: An in depth understanding of immediate skin responses

High‐velocity pneumatic injection of non‐crosslinked hyaluronic acid for skin regeneration and scar remodeling: A retrospective analysis of 115 patients

Biochemical and physical actions of hyaluronic acid delivered by intradermal jet injection route

Contact Info

Product

Resources

About