EVALUATION OF HYALURONIC ACID AS A TISSUE FILLER

Abstract

Efforts to develop the perfect soft tissue augmentation material continue. Autogenous materials such as fat remain the safest implant, but are often limited by their duration of correction and need for touch-up procedures. Autologous injectable collagen is a great option for patients already undergoing a cosmetic procedure with excess skin availabl e for the manufacturi ng process. Allogenic materials, such as Alloderm and Dermalogen, may gain popu larity but requ i re patient and physician trust in the manufacturer to prevent viral and prion contamination. Gore-tex and the new soft form implant will remain reliable and useful, but may continue to be palpable when pl aced subcutaneously. Bovine collagen, •a xenograft with a l ong track record, continues to be a mainstay until longer l asting injectables are proven safe and effective. Hyaluronic acid derivatives may become a popular alternative to bovi ne collagen needing no skin testing. Hyal uronic acid has been suggested to be • essential • for cell proliferation and migration. At present attention focuses on the beneficial actions of H.A. in wou nd heali ng. The water-binding prope1ty associated with H.A. may serve as a means for water homeostasis in the skin. Alterations of H.A. play a major role in the pathophysiology of aged skin. The variations of H.A. in the dermis associated with intrinsic aging could accou nt for some