title: Skin Remodeling Using Hyaluronic Acid Filler Injections in Photo-Aged Faces.
abstract: BACKGROUND
  Hyaluronic acid (HA) filler is an important dermatological procedure. Although many studies have reported clinical improvement with this procedure, histology with morphometric evidence is not well documented.
  
  
  OBJECTIVE
  To evaluate the clinical and histological results of a HA filler injection and to quantify dermis remodeling at 3 and 9 months after HA injections into aged faces.
  
  
  METHODS
  Twenty patients were enrolled in this study. Hyaluronic acid filler was injected into the nasolabial folds and preauricular regions of the patients. Skin biopsies of the preauricular regions were performed before the procedure and at 3 and 9 months after the procedure.
  
  
  RESULTS
  Sixteen women (aged 40-50 years) completed the clinical study and demonstrated improvement for 12 months. Twenty patients completed the histologic studies. Morphologic evaluation showed increases in the epidermal layers. The morphometric study showed a statistically significant increase in collagen fibers at 3 and 9 months after the procedure (34.2% ± 31.5% and 39.5% ± 39.7%, respectively, p < .05).
  
  
  CONCLUSIONS
  Sustained clinical results for HA filler can be explained not only by the presence of HA gel on the dermis but also by the dermal remodeling induced by HA filler injected into the face.
authors.affiliation: *Department of Medical Sciences, Fluminense Federal University, Niterói, Brazil; Bonsucesso Federal Hospital, Rio de Janeiro, Brazil; †Department of Dermatology, Fluminense Federal University, Niterói, Brazil; ‡Department of Biostatistics, Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; §Department of Pathology, Fluminense Federal University, Niterói, Brazil; ‖Department of Immunology, Fluminense Federal University, Niterói, Brazil.
authors.forename: Fabiana Braga
authors.initials: FB
authors.lastname: França Wanick
authors.forename: Maria Claudia
authors.initials: MC
authors.lastname: Almeida Issa
authors.forename: Ronir Raggio
authors.initials: RR
authors.lastname: Luiz
authors.forename: Porphirio José
authors.initials: PJ
authors.lastname: Soares Filho
authors.forename: Beni
authors.initials: B
authors.lastname: Olej
mesh_terms: D000328:Adult; D001706:Biopsy; D002610:Cheek; D003094:Collagen / Q000648:ultrastructure; D000067548:Dermal Fillers / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold; D011446:Prospective Studies; D012867:Skin / Q000473:pathology; D015595:Skin Aging / Q000187:drug effects / Q000473:pathology* / Q000502:physiology*; D013997:Time Factors
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid; D003094:Collagen