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Related Experiment Video

Updated: Feb 7, 2026

Evaluation of the Interplay Between the Complement Protein C1q and Hyaluronic Acid in Promoting Cell Adhesion
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Hyaluronic Acid After Subcutaneous Injection-An Objective Assessment.

Verena Santer1, Samuel Gavard Molliard2, Patrick Micheels3

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Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [Et Al.]
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Three hyaluronic acid (HA) fillers, despite distinct biophysical properties, showed similar subcutaneous distribution in skin. This suggests HA filler formulation does not impact its immediate dispersion in the hypodermis.

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Area of Science:

  • Dermatology
  • Aesthetic Medicine
  • Biomaterials Science

Background:

  • Hyaluronic acid (HA) fillers are widely used for aesthetic correction and facial volume restoration.
  • Understanding the in-situ behavior of HA fillers is crucial for optimizing treatment outcomes and patient safety.

Purpose of the Study:

  • To investigate and compare the subcutaneous distribution patterns of three distinct, CE-marked and FDA-approved HA fillers.
  • To evaluate the impact of varying biophysical properties on the immediate dispersion of HA fillers within the skin's hypodermal layer.

Main Methods:

  • Ex vivo injection of three HA fillers (BELB, JUVV, RESL) into porcine and human skin samples.
  • Immediate post-injection analysis using stereomicroscopy and full-field optical coherence tomography (OCT) on snap-frozen, cross-sectioned samples.
  • Comparison of visualization results with histological sections stained with hematoxylin and eosin.

Main Results:

  • All investigated HA fillers distributed as homogeneous boluses within the subcutaneous tissue.
  • The injected HA filler volumes preserved the fibrous trabecular network and displaced adjacent fat lobules and adipocyte layers.
  • No significant differences in distribution patterns were observed among the three HA fillers, irrespective of their distinct biophysical properties.

Conclusions:

  • This study provides the first systematic investigation of subcutaneous HA filler distribution using complementary visualization techniques.
  • Despite marked differences in biophysical properties, the investigated HA fillers exhibit similar distribution behavior upon subcutaneous injection.
  • The observed preservation of the hypodermis structure supports the clinical findings of good tolerability associated with these HA fillers in the subcutaneous skin layer.