Comparative analysis of hyaluronic acid fillers: Juvéderm Volux versus MaiLi Extreme in microstructural, rheological...

Crosslinked hyaluronic acid fillers (e.g., Juvéderm Volux, MaiLi Extreme [MaiLi-E]) are widely used for deep tissue augmentation, yet systematic comparative analyses are lacking, limiting evidence-based clinical selection. This study provides a systematic comparison across multiple parameters, including the degree of modification, rheological properties, mechanical behavior, and microstructural characteristics, with a preliminary clinical observation of MaiLi-E in chin retrusion correction.

Degree of modification was measured via solution-state ¹H NMR. Elastic modulus (G'), thixotropic index and normal force under compression were measured using a rotational rheometer. Cohesivity was assessed by a drop weight method. Microstructure was examined via scanning electron microscopy (SEM). Chin retrusion patients received a single MaiLi-E injection without touch-ups. The outcomes were evaluated at 3, 6, and 12 months via standardized photographs.

MaiLi-E showed lower modification degree (4.86% vs. Juvéderm Volux's 12.26%), lower G' (262 Pa vs. 589 Pa), but higher thixotropic index (5.8 vs. 4.3, +25.9%), normal force (60.89 cN vs. 43.36 cN, +28.8%), and cohesivity (0.2099 g vs. 0.1217 g, +42.0%). SEM revealed MaiLi-E's denser, more uniform microstructure. Clinically, two patients achieved sustained chin retrusion correction at 12 months post-single injection.

MaiLi-E exhibited enhanced cohesivity and compression resistance while achieving improved injectability relative to Juvéderm Volux, despite possessing a lower degree of modification. Furthermore, a preliminary clinical observation in human subjects confirmed that MaiLi-E is expected to be applied to chin retrusion correction. These findings indicate that MaiLi-E holds potential in deep tissue augmentation applications, thereby offering practitioners an evidence-based product reference.