Soft Tissue Fillers
and more to enhance or replace lost skin volume in a variety of areas such as the laugh lines, lips, cheeks, hollow temples, back of hands and more (may include off label uses).
FDA-APPROVED HYALURONIC ACID FILLERS
(Chart by M. Lum, D.O., Lumier Medical, Inc., 10-2017)°
°DISCLAIMER: This chart was created as an educational resource only by compiling a combination of evidence-based data published by the manufacturer, by third-party publications, and educational resources available to both health care providers and consumers. The author attests that content is subject to correction and future updates should the need arise. This information is not intended as a substitute for clinical expertise and judgment by a qualified healthcare provider.
*Longevity claims need to consider a variety of factors, which include clinical trials study design, methodology, amount of filler injected, and treatment area. When comparing patient to patient variability, other factors such as patient’s metabolism and soft-tissue matrix need to be considered.
**Restylane was shown to maintain correction at 18 months following repeat injection at 4.5 months. This study led to a second submission to the FDA, known as a supplemental Premarket Approval Application for its label, giving a new indication for Restylane—longevity up to 18 months with repeat injection at 4.5 months.
***G’ (pronounced G prime) is the elastic modulus or measure of gel stiffness, increases with the degree of cross-linking, estimates resistance to deformation. “The ability of a filler to lift up soft tissue such as skin is directly related to the G prime, but it’s also directly related to the cohesivity,” Dr. Jones says. “Increasing the cohesivity and decreasing the G prime is a fundamental feature of homogenized HAs compared to particle-based fillers, which rely on a higher G prime to create lift. Whereas the Restylane filler family relies on a high G prime to achieve lift, the Juvéderm family relies on higher cohesivity.”
Juvéderm Voluma (HA, Galderma) is a good example of a filler that achieves a significant lift capacity by employing a high cohesivity but a lower G prime compared to the Restylane family, Dr. Jones says. It is currently undergoing FDA trials to become the first HA filler indicated in the United States for midface volumizing in the normal, non-HIV- infected host, says Dr. Jones, who is a principal investigator on this phase 3 study.
All fillers listed above are available in 1ml syringe sizes, except for Juvéderm Volbella, which comes in a 0.55ml syringe. All except for Belotero Balance are available with 0.3% Lidocaine.
NASHA = Trademark of Q-Med (owned by Galderma) stands for Non-Animal, Stabilized Hyaluronic Acid.
Hylacross = Trademark of Allergan. “Hyla-“ derives from “Hyaluronic Acid.” “Cross” implies “cross-linking.”
xPresHAn = Trademark of Galderma. XpresHAn Technology customizes the degree of hyaluronic acid (HA) crosslinking in each product, resulting in gels with a range of flexibility and support characteristics for different patient needs. The “x” stands for “cross-linking.” “Pres,” because gels are pressed through a mesh for calibration. “HA” stands for Hyaluronic Acid. The “n” was simply added to the end to make it sound more like a familiar word.
Vycross = Trademark of Allergan. Uses a combination of low and high molecular weight HA to improve the cross-linking efficiency of HA chains. Vollure ® is known as Volift ® in countries outside the United States.
CPM = Cohesive Polydensified Matrix