title: Durability of Three Different Types of Hyaluronic Acid Fillers in Skin: Are There Differences Among Biphasic, Monophasic Monodensified, and Monophasic Polydensified Products?
abstract: Hyaluronic acid fillers are used for facial rejuvenation and are classified as non-cross-linked or cross-linked (monophasic mono- or polydensified).
  
  
  
  To histologically assess the intradermal durability of three types of fillers (biphasic, monophasic monodensified, and monophasic polydensified), to compare the durability of the products over 6 months, and to evaluate the structural changes after application.
  
  
  
  In all, 25 volunteers received injections of three different fillers in the dermis of the right lumbar region (in one line), and equal amounts of the fillers were injected into three different sites (in the same column), yielding nine points of application in each patient. Each line was biopsied on days 2, 92, and 184; these skin samples were analyzed histologically, and the presence or absence of these fillers was verified by a dermatopathologist.
  
  
  
  The histological analysis showed that over 182 days, the amount of the injected monophasic polydensified, monophasic monodensified, and biphasic filler products decreased by 62.5%, 25%, and 12.5%, respectively.
  
  
  
  The biphasic and monophasic monodensified fillers presented greater intradermal durability than did the monophasic polydensified filler at 6 months after intradermal injection.
authors.affiliation: Research Fellow, Department of Dermatology, Emory University School of Medicine, Atlanta, GA, USA.|Former Dean, Department of Dermatology, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
authors.forename: Adilson
authors.initials: A
authors.lastname: da Costa
authors.affiliation: Department of Dermatology, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
authors.forename: Danilo Guerreiro Zeolo
authors.initials: DGZ
authors.lastname: Biccigo
authors.affiliation: Department of Dermatology, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
authors.forename: Ellem Tatiani
authors.initials: ET
authors.lastname: de Souza Weimann
authors.affiliation: Department of Dermatology, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
authors.forename: Larissa Mondadori
authors.initials: LM
authors.lastname: Mercadante
authors.affiliation: Pathologist and President, Pathos Medical Diagnostics, Sao Paulo, SP, Brazil.
authors.forename: Paulo Roberto Grimaldi
authors.initials: PRG
authors.lastname: Oliveira
authors.affiliation: Student of Medicine, Pontifical Catholic University of Campinas, Campinas, SP, Brazil.
authors.forename: Stefânia Bazanelli
authors.initials: SB
authors.lastname: Prebianchi
authors.affiliation: Resident of Internal Medicine, ABC Medical School, Santo Andre, SP, Brazil.
authors.forename: Beatrice Martinez Zugaib
authors.initials: BMZ
authors.lastname: Abdalla
mesh_terms: D001706:Biopsy; D003357:Cosmetic Techniques; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000737:chemistry*; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000737:chemistry*; D007271:Injections, Intradermal; D008875:Middle Aged; D011446:Prospective Studies; D012060:Rejuvenation; D012867:Skin / Q000033:anatomy & histology; D014783:Viscosity
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid