journal article·2021-08-16Open access

Non-Surgical Touch-Up with Hyaluronic Acid Fillers Following Facial Reconstructive Surgery

Fabrizio Chirico, Giuseppe Colella, Antonio Cortese, Pierfrancesco Bove, Romolo Fragola, Luigi Rugge, Giovanni Audino, Nicola Sgaramella, Gianpaolo Tartaro

Applied Sciences· Volume 11· Issue 16

Abstract

The use of hyaluronic acid (HA) injectable fillers has become increasingly widespread in facial recontouring and rejuvenation. We report our experiences to emphasize the role of HA fillers as tools beyond aesthetic treatments in cases of post-surgical facial sequelae. HA fillers are generally used for aesthetic rejuvenation, but one potential new horizon could be their application in trauma, reconstructive, and craniofacial surgery. This study was conducted retrospectively, evaluating medical reports of patients treated at the Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, for lip incompetence, trauma, oncological, reconstructive, and craniosynostosis surgery sequelae. Visual analog scale (VAS) evaluation was performed to assess patient satisfaction. No major complications (i.e., impending necrosis or visual loss) were reported. Bruising and swelling was reported for 48 h after lip injection. At the immediate VAS evaluation, 67% of the patients were “extremely satisfied” and 33% “satisfied”. In those 33%, VAS scores changed to “extremely satisfied” at 6–9 weeks and 3–6 months of VAS evaluation (contextually to improvement in tissue flexibility, elasticity, and aesthetic appearance). Results indicate that this minimally invasive approach achieves a high level of aesthetic enhancement, improving patient satisfaction. The concept of HA filler applications could be a frontier that may be applicable to other areas of reconstructive facial plastic surgery.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Facial Rejuvenation and Surgery Techniques · Reconstructive Facial Surgery Techniques · Facial Nerve Paralysis Treatment and Research

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Independent Researcher, 80136 Naples, Italy

Maxillofacial Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialities, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy

Maxillofacial Surgery Unit, Department of Medicine and Surgery, University of Salerno, 84125 Salerno, Italy

Independent Researcher, 20121 Milan, Italy

Independent Researcher, 73100 Lecce, Italy

Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy

Independent Researcher, 70125 Bari, Italy

References (100+)

Show source-provided references
1. Fettransplantation
2. Semipermanent and Permanent Injectable Fillers10.1016/j.det.2009.08.003 ↗
3. An Overview of Permanent and Semipermanent Fillers10.1097/01.prs.0000234900.26676.0b ↗
4. Chirico, F., Bove, P., Fragola, R., Cosenza, A., De Falco, N., Giudice, G.L., Audino, G., and Rauso, G. (2021). Biphasic Injection for Masseter Muscle Reduction with Botulinum Toxin. Appl. Sci., 11.10.3390/app11146478 ↗
5. Rhinofilling with hyaluronic acid thought as a cartilage graft10.1016/j.jcms.2020.01.008 ↗
6. The myth of the “biphasic” hyaluronic acid filler10.1097/DSS.0000000000000545 ↗
7. Lift capabilities of hyaluronic acid fillers10.3109/14764172.2011.552609 ↗
8. Rauso, R., Giudice, G.L., Zerbinati, N., and Tartaro, G. (2019). Hyaluronic Acid Injections as Nonsurgical Alternative in case of Delayed Diagnosis of Malar Arch Fracture: Case Report and Literature Review. Case Rep. Surg., 1360741.10.1155/2019/1360741 ↗
9. Update on the Treatment of Scars
10. Revision of a depressed scar across a relaxed skin tension line by punch elevation, filler injection, and fractional CO2 laser
11. Restoring facial symmetry through non-surgical cosmetic procedures after permanent facial paralysis: A case report
12. Continuum: Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy10.1093/asj/sjz030 ↗
13. Late onset complications secondary to polyacrylamide hydrogel-based filler for rehabilitation of HIV-related facial lipoatropy10.1093/asj/sjy226 ↗
14. 5-Year Study of a Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatrophy10.1093/asj/sjv036 ↗
15. Safety and Efficacy of a Volumizing Hyaluronic Acid Filler for Treatment of HIV-Associated Facial Lipoatrophy10.1001/jamadermatol.2016.3827 ↗
16. A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA)10.1016/j.jaad.2015.08.040 ↗
17. Chirico, F., Rauso, G., Fragola, R., Giudice, G.L., Pinto, L., De Falco, N., Cosenza, A., Rugge, L., Sgaramella, N., and Tartaro, G. (2021). Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience. Appl. Sci., 11.10.3390/app11094059 ↗
18. Facial Injections of Hyaluronic Acid-Based Fillers for Malformations. Preliminary Study Regarding Scar Tissue Improvement and Cosmetic Betterment10.1016/j.anplas.2018.01.001 ↗
19. Tissue Expansion Using Hyaluronic Acid Filler for Single-Stage Ear Reconstruction: A Novel Concept for Difficult Areas10.1093/asj/sjx119 ↗
20. Craniosynostosis—Recognition, Clinical Characteristics, and Treatment
21. Nonsyndromic Craniosynostosis10.1016/j.cps.2018.11.001 ↗
22. Hydroxyapatite Cement Paste Cranioplasty for the Treatment of Temporal Hollowing After Cranial Vault Remodeling in a Growing Child10.1097/00001665-199711000-00017 ↗
23. Onlay Bone Graft Augmentation for Refined Correction of Coronal Synostosis10.1597/1545-1569(2002)039<0546:OBGAFR>2.0.CO;2 ↗
24. Calcium Phosphate Cement Cranioplasty: Clinical and Radiographic Follow-up
25. Prevention of “Temporal Hollowing” After Fronto-orbital Advancement for Craniosynostosis10.1097/00001665-199409000-00018 ↗
26. Parry–Romberg syndrome: Volumetric regeneration by structural fat grafting technique10.1016/j.jcms.2010.02.005 ↗
27. Structural fat grafting: Facial volumetric restoration in complex reconstructive surgery10.1097/SCS.0b013e31822e5d5e ↗
28. Effects of ischemic preconditioning with resveratrol on epigastric rat flap: New perspectives for head and neck reconstruction
29. A rare case of Brooke-Spiegler syndrome: Integrated surgical treatment of multiple giant eccrine spiradenomas of the head and neck in a young girl10.1016/j.ijscr.2018.08.021 ↗
30. Electrocochleography Observations in a Series of Cochlear Implant Electrode Tip Fold-Overs10.1097/MAO.0000000000003008 ↗
31. The role of lipofilling in reconstructions with dermal regeneration template: Clinical and histological assessment
32. The fat cell ‘graft’, a new technique to fill depressions10.1097/00006534-198607000-00028 ↗
33. Body contouring by lipolysis: A five-year experience with over 3000 cases10.1097/00006534-198311000-00001 ↗
34. De l’utilization de la graisse aspiree pour combler les defects cutanes observations
35. Injection of Fat for Soft Tissue Augmentation10.1288/00005537-198901000-00010 ↗
36. Blindness following fat injections [letter]10.1097/00006534-198808000-00036 ↗
37. Present results of fat injection10.1007/BF01570929 ↗
38. Evidence-Based Medicine: Liposuction10.1097/PRS.0000000000002859 ↗
39. Autologous fat transplantation: A 3-year study [abstract]10.1177/074880688700400203 ↗
40. Adipose Tissue in Plastic Surgery10.1097/00000637-198605000-00012 ↗
41. Methode de production de collagene autologue par traitement du tissue graisseux
42. The Tumescent Technique for Lipo-Suction Surgery10.1177/074880688700400403 ↗
43. Historical review and present status of free graft and autotransplantation in plastic and reconstructive surgery10.1097/00006534-198902000-00033 ↗
44. Combined scalp reduction and autologous fat implant treatment of localized soft tissue defects10.1111/j.1524-4725.1988.tb03342.x ↗
45. Free-fat injections for the correction of hemifacial atrophy10.1097/00006534-198909000-00020 ↗
46. Fat Grafting for Facial Rejuvenation with Nanofat Grafts10.1016/j.cps.2019.08.006 ↗
47. Shukla, L., Yuan, Y., Shayan, R., Greening, D., and Karnezis, T. (2020). Fat Therapeutics: The Clinical Capacity of Adipose-Derived Stem Cells and Exosomes for Human Disease and Tissue Regeneration. Front. Pharmacol., 11.10.3389/fphar.2020.00158 ↗
48. Adipose tissue-derived stromal vascular fraction in regenerative medicine: A brief review on biology and translation10.1186/s13287-017-0598-y ↗
49. The scientific basis for lipotransfer: Is it the ideal filler?10.1016/j.fsc.2008.05.005 ↗
50. Structural fat grafting: More than a permanent filler10.1097/01.prs.0000234610.81672.e7 ↗
51. Expansion Vibration Lipofilling: A New Technique in Large-Volume Fat Transplantation10.1097/PRS.0000000000004338 ↗
52. Procedure, applications, and outcomes of autologous fat grafting10.1016/j.amsu.2017.06.059 ↗
53. Particle size in fat graft retention: A review on the impact of harvesting technique in lipofilling surgical outcomes10.4161/21623945.2014.957987 ↗
54. Gentle is better: The original “gentle technique” for fat placement in breast lipofilling10.4103/JCAS.JCAS_24_18 ↗
55. Loss of weight and volume in human fat grafts: With postulation of a “cell survival theory”10.1097/00006534-195003000-00002 ↗
56. Comparative study of survival of autologous adipose tissue taken and transplanted by different techniques10.1097/00006534-199003000-00007 ↗
57. Bioactivation of free-fat transfers: A potential new approach to improving graft survival
58. Survival of Autologous Fat Grafts in Humans and in Mice10.3109/03008208109152128 ↗
59. Experimental study of the behavior of free fat transplants
60. Body Contouring by Macroinjection of Autogenous Fat10.1177/074880688700400204 ↗
61. Quantitative Assessment of Augmentation Therapy10.1111/j.1524-4725.1990.tb00027.x ↗
62. Technique for Liposuction Fat Reimplantation and Long-Term Volume Evaluation by Magnetic Resonance Imaging10.1097/00000637-199103000-00007 ↗
63. Autologous fat grafting in breast cancer patients10.1016/j.breast.2012.06.002 ↗
64. Application of Cell Therapy for Anti-Aging Facial Skin10.2174/1574888X13666181113113415 ↗
65. The regenerative role of adipose-derived stem cells (ADSC) in plastic and reconstructive surgery10.1111/iwj.12569 ↗
66. The Basic Mechanism of Hair Growth Stimulation by Adipose-derived Stem Cells and Their Secretory Factors10.2174/1574888X12666170829161058 ↗
67. Validation of volumetric and single-slice MRI adipose analysis using a novel fully automated segmentation method10.1002/jmri.24526 ↗
69. Injectable Fillers in the Upper Face10.1016/j.cxom.2016.05.004 ↗
70. Mechanisms of Fat Graft Survival10.1097/SAP.0000000000000730 ↗
71. Aging Changes of the Periorbita, Cheeks, and Midface10.1055/s-0033-1333840 ↗
72. Autologous Fat Transplantation: Volumetric Tools for Estimation of Volume Survival. A Systematic Review10.1007/s00266-012-0046-4 ↗
73. Autologous Fat Transfer National Consensus Survey: Trends in Techniques for Harvest, Preparation, and Application, and Perception of Short- and Long-Term Results10.1097/01.prs.0000244903.51440.8c ↗
74. Delayed two steps PRP injection strategy for the improvement of fat graft survival with superior angiogenesis10.1038/s41598-020-61891-6 ↗
75. Platlet Rich Plasma (PRP) Improves Fat Grafting Outcomes
76. Reliable soft tissue augmentation: A clinical comparison of injectable soft-tissue fillers for facial-volume augmentation10.1097/01.sap.0000168292.69753.73 ↗
77. Complications Associated with Fat Grafting to the Lower Eyelid10.1016/j.fsc.2019.07.001 ↗
78. Complications in Fat Grafting10.1016/j.cxom.2017.11.003 ↗
79. A case of autologous microfat grafting in lip reconstruction of a whistle deformity following cancer treatment10.1177/229255031001800401 ↗
80. Hyaluronic acid is superior to autologous fat for treatment of temporal hollowing after lateral orbital wall decompression: A prospective interventional trial10.1016/j.bjps.2018.12.031 ↗
81. Autologous fat grafting and injectable dermal fillers for human immunodeficiency virus-associated facial lipodystrophy: A comparison of safety, efficacy, and long-term treatment outcomes10.1097/PRS.0b013e31827c6df5 ↗
82. The Youthful Cheek and the Deep Medial Fat Compartment10.1097/PRS.0b013e31817123c6 ↗
83. In Vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photo-damaged human skin10.1001/archderm.143.2.155 ↗
84. Zerbinati, N., Sommatis, S., Maccario, C., Capillo, M., Grimaldi, G., Alonci, G., Protasoni, M., Rauso, R., and Mocchi, R. (2021). Toward Physicochemical and Rheological Characterization of Different Injectable Hyaluronic Acid Dermal Fillers Cross-Linked with Polyethylene Glycol Diglycidyl Ether. Polymers, 13.10.3390/polym13060948 ↗
85. Zerbinati, N., Esposito, C., Cipolla, G., Calligaro, A., Monticelli, D., Martina, V., Golubovic, M., Binic, I., Sigova, J., and Gallo, A.L. (2020). Chemical and mechanical characterization of hyaluronic acid hydrogel cross-linked with polyethylen glycol and its use in dermatology. Dermatol. Ther., 33.10.1111/dth.13747 ↗
86. Chemical Characterization of Hydrogels Crosslinked with Polyethylene Glycol for Soft Tissue Augmentation10.3889/oamjms.2019.279 ↗
87. Marino, F., Cosentino, M., Legnaro, M., Luini, A., Sigova, J., Mocchi, R., Lotti, T., Zerbinati, N., Gasperina, D., and Tirant, M. (2020). Immune profile of hyaluronic acid hydrogel polyethylene glycol crosslinked: An in vitro evaluation in human polymorphonuclear leukocytes. Dermatol. Ther., 33.10.1111/dth.13388 ↗
88. Morphological evidences following pegylated filler treatment in human skin
89. In Vitro Evaluation of the Sensitivity of a Hyaluronic Acid PEG Cross-Linked to Bovine Testes Hyaluronidase10.3889/oamjms.2018.046 ↗
90. Unusual Intraoral Necrosis After Hyaluronic Acid Injections10.1097/DSS.0000000000003099 ↗
91. Rauso, R., Zerbinati, N., Franco, R., Chirico, F., Ronchi, A., Sesenna, E., Colella, G., and Tartaro, G. (2020). Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios. Dermatol. Ther., 33.10.1111/dth.13269 ↗
92. Is hyaluronidase able to reverse embolism associated with hyaluronic acid filler? An anatomical case study
93. Skin Necrosis and Vision Loss or Impairment After Facial Filler Injection10.1097/SCS.0000000000007047 ↗
94. Zerbinati, N., Mocchi, R., Galadari, H., Maccario, C., Maggi, M., Rauso, R., Passi, A., Esposito, C., and Sommatis, S. (2019). In Vitro Evaluation of the Biological Availability of Hyaluronic Acid Polyethylene Glycols-Cross-Linked Hydrogels to Bovine Testes Hyaluronidase. BioMed Res. Int.10.1155/2019/3196723 ↗
95. In Vitro Evaluation of the Biosafety of Hyaluronic Acid PEG Cross-Linked with Micromolecules of Calcium Hydroxyapatite in Low Concentration10.3889/oamjms.2018.044 ↗
96. Resistant and Recurrent Late Reaction to Hyaluronic Acid–Based Gel10.1097/DSS.0000000000000562 ↗
97. Safety data of injectable nonanimal stabilized hyaluronic acid gel for soft tissue augmentation
98. Final Report of the Safety Assessment of Hyaluronic Acid, Potassium Hyaluronate, and Sodium Hyaluronate10.1177/1091581809337738 ↗
99. Salti, G., and Fundarò, S.P. (2020). Evaluation of the Rheologic and Physicochemical Properties of a Novel Hyaluronic Acid Filler Range with eXcellent Three-Dimensional Reticulation (XTR™) Technology. Polymers, 12.10.3390/polym12081644 ↗
100. Hyaluronic Acid Fillers in Soft Tissue Regeneration10.1055/s-0036-1597685 ↗