A blanching technique for intradermal injection of the hyaluronic acid Belotero.
With the proliferation of dermal fillers in the aesthetic workplace have come instructions from various manufacturers regarding dermal placement. Determination of injection needle location in the dermis has in large part been based on physician expertise, product and needle familiarity, and patient-specific skin characteristics. An understanding of the precise depth of dermal structures may help practitioners improve injection specificity. Unlike other dermal fillers that suggest intradermal and deep dermal injection planes, a new hyaluronic acid with a cohesive polydensified matrix may be more appropriate for the superficial dermis because of its structure and its high degree of integration into the dermis. To that end, the authors designed a small study to quantify the depth of the superficial dermis by means of ultrasound and histology. Using ultrasound resources, the authors determined the depths of the epidermis, the dermis, and the reticular dermis in the buttocks of six patients; the authors then extrapolated the depth of the superficial reticular dermis. Histologic studies of two of the patients showed full integration of the product in the reticular dermis. Following determination of injection depths and filler integration, the authors describe a technique ("blanching") for injection of the cohesive polydensified matrix hyaluronic acid into the superficial dermis. At this time, blanching is appropriate only for injection of the cohesive polydensified matrix hyaluronic acid known as Belotero Balance in the United States, although it may have applications for other hyaluronic acid products outside of the United States.
Geneva, Switzerland; Rockville, Md.; Fairfax, Va.; and Cary and Chapel Hill, N.C. From private practice; Laboratoire Viollier Weintraub; MedImage, Radiology Center; Cary Skin Center; and the Department of Dermatology, University of North Carolina at Chapel Hill.
Patrick
P
Micheels
Didier
D
Sarazin
Stéphanie
S
Besse
Hema
H
Sundaram
Timothy C
TC
Flynn
D000328:Adult; D003357:Cosmetic Techniques; D020405:Dermis; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007271:Injections, Intradermal / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019736:Prostheses and Implants
D006820:Hyaluronic Acid