Chemical Denervation Aids Dermal Fillers Last Longer

A new study suggests that combining hyaluronic acid (HA) dermal fillers with botulinum toxin could slow down their degradation process.

Researchers at Ondokuz Mayis University (Samsun, Turkey) designed a study in rabbits in which a small amount of HA filler was injected under the skin in front of each ear; the area was chosen because it corresponds to the forehead region in humans, a common area for dermal fillers. On one side, HA filler alone was used; on the other, HA filler was combined with botulinum neurotoxin-A (BoNT-A) to paralyze the muscle in that area. Two days later, magnetic resonance imaging (MRI) scans were performed to compare the amount of filler remaining on both sides. After three months, MRI scans were repeated.

The results showed that the average initial volume of filler was 0.61 cm³ on both sides. At the end of three months, however, the average degraded volume of the filler-only side was 0.33 cm³, compared to 0.19 cm³ on the combined HA- BoNT-A side, a diminished degradation rate of 42%. The difference was visible as well as measurable, supporting the clinical experience that local BoNT-A injection provides longer-lasting outcomes in patients. The study was published in the January 2016 issue of Plastic and Reconstructive Surgery.

“This study showed that HA filler application in combination with BoNT-A significantly decreases the degradation process and increases the remaining volume at the end of the paralyzed period,” concluded lead author İsmail Küçüker, MD, and colleagues of the department of plastic surgery. “The study provides objective evidence to support the use of this combination procedure in patients undergoing dermal filler treatments.”

HA is an anionic, nonsulfated glycosaminoglycan distributed widely in connective, epithelial, and neural tissues. One of the chief components of the extracellular matrix (ECM), it contributes significantly to cell proliferation and migration, and may also be involved in the progression of some malignant tumors. HA fillers are a popular treatment option for facial lines and wrinkles, but early degradation of fillers may limit how long their effects last.

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Ondokuz Mayis University