CC BY 4.0 · Arch Plast Surg 2024; 51(01): 014-019
DOI: 10.1055/a-2234-1019
Cosmetic
Original Article

“Cohesiveness of Hyaluronic Acid Fillers”: Evaluation Using Multiple Cohesion Tests

Kyun Tae Kim 
1   Yonsei Dain Plastic Surgery Clinic, Seoul, South Korea
2   Scientific Faculty of the Minimal Invasive Plastic Surgery Association, Seoul, South Korea
,
Won Lee 
2   Scientific Faculty of the Minimal Invasive Plastic Surgery Association, Seoul, South Korea
3   Yonsei E1 Plastic Surgery Clinic, Anyang, South Korea
,
Eun-Jung Yang 
2   Scientific Faculty of the Minimal Invasive Plastic Surgery Association, Seoul, South Korea
4   Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, South Korea
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Abstract

Background Hyaluronic acid fillers can be manufactured using various processes. They have multiple properties, including their concentration, degree of modification, and rheological data. Cohesion is one such property to evaluate gel integrity; however, there is no standardized method for calculating this parameter. This study aimed to evaluate different tests for calculating hyaluronic acid cohesion and discuss the importance of hyaluronic acid cohesion as a consideration when selecting fillers.

Methods The cohesion levels of five different hyaluronic acid fillers with different rheological properties were evaluated and compared using the drop weight, compression, tack, and dispersion time tests.

Results The cohesion tests yielded different results in the samples. Samples 2 and 4 showed approximately two times the number of droplets when compared with Sample 5 in drop weight test. Samples 1, 2, 3, and 4 were superior to Sample 5 in tack test. Samples 1, 2, and 3 showed cohesive appearances at 95 seconds in most cases in dispersion test. Rheological test results did not reflect the measures of cohesion.

Conclusion Although there are no definite standardized tests to evaluate the cohesion of hyaluronic acid fillers, our proposed tests showed similar results for different hyaluronic acid filler products. Further studies are needed to evaluate the cohesion of hyaluronic acid fillers and determine the clinical use of this distinguishing characteristic for clinicians selecting the product of choice.

Level of evidence statement: These data are Level IV evidence.

Keywords

soft tissue filler - hyaluronic acid filler - cohesion - filler property

Authors' Contributions

Conceptualization, K.T.K. and W.L.; methodology, K.T.K.; validation, W.L. and E.J.Y.; formal analysis, W.L. and E.J.Y.; investigation, K.T.K.; resources, K.T.K.; writing --original draft preparation, W.L.; writing --review and editing, W.L. and E.J.Y.; visualization, W.L.; supervision, E.J.Y.; project administration, K.T.K. and W.L.




Publication History

Received: 03 June 2023

Accepted: 24 November 2023

Accepted Manuscript online:
21 December 2023

Article published online:
24 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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