Why is Acido Hialuronico Fillers Better?
Benefits of Hyaluronic Acid Soft Tissue Fillers
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Abstract
Background
Hyaluronic acid (HA) soft tissue fillers are popular for volumizing, sculpting, or rejuvenating the face. Their effects extend beyond cosmetic benefits but remain poorly defined, particularly in the psychological and social dimensions of health following cosmetic HA filler injections.
Objectives
The study aims to determine whether injecting more facial aesthetic units with HA soft tissue filler can improve patients' health-related quality of life.
Methods
A prospective study assessed the psychological and social benefits of treating multiple facial aesthetic units with HA soft tissue filler using three validated FACE-Q scales at baseline and four weeks posttreatment between January and August 2022.
Results
Data from 28 participants (93% females, mean age 49.7) revealed significant improvements in psychological (+24.5; P < 0.001) and social functioning (+18.5; P < 0.001) FACE-Q scales and a reduction in appearance-related distress score (–17.8; P < 0.001). A mean volume of 4.7 mL (range 1.0-15.2 mL) was injected. However, patients with more than two facial aesthetic units injected did not statistically score better on the FACE-Q scales.
Conclusions
Facial treatment with HA fillers was linked to notable improvements in health-related quality of life. Understanding patients' aims and motivations is crucial, encouraging an individualized treatment approach over a "whole-face" method.
Understanding Facial Aging
Facial aging involves many processes, resulting in bone remodeling, fat compartment changes, ligamentous support loss, and altered muscle activity. Superficially, it manifests as skin atrophy and loss of elasticity and hydration, causing visible changes. The aging phenotype is often associated with negative emotions and poor psychological and social health, motivating the popularity of aesthetic medicine for rejuvenation procedures.
Facial appearance is closely related to perceived physical attractiveness, which has strong psychological and social implications. Attractive children receive positive treatment, and attractive adolescents are more popular, independent of academic performance. In professional environments, attractiveness can lead to better job opportunities and higher wages.
Newer soft tissue fillers made of HA emerged in the 21st century, offering practitioners increased versatility and indications for use in facial aesthetics. HA fillers are used for decreasing folds, correcting lines, facial contouring, shaping, volumizing, hydration, myomodulation, reducing wrinkles, and improving facial symmetry and harmony.
Study Design
This prospective single-center clinical study, conducted from January 2022 to August 2022, involved patients seeking HA soft tissue filler treatments. The study received ethical approval and adhered to clinical practice and regional regulations.
Population Study
Thirty participants (93% females) with a mean age of 49.7 were included. FACE-Q questionnaires assessing psychological, appearance, and social functions were administered pre- and post-treatment. Inclusion criteria ensured participants had no prior facial treatments or surgeries and could provide informed consent.
FACE-Q Questionnaires
The FACE-Q aesthetics module includes domains measuring health-related quality of life: Psychological Function, Appearance Distress, and Social Function, using a 4-point agreement scale. The questionnaires assess happiness, attractiveness, confidence, distress, and social confidence related to facial appearance.
Facial Aesthetic Units
The face is divided into specific "aesthetic units" with similar characteristics. These units are separated by "aesthetic borders" like the hairline, eyebrows, and nasolabial fold.
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Treatment Techniques
Treatment plans were personalized based on patient consultations. HA fillers from the Juvederm brand were used, injected via needle or cannula depending on clinical indications. Injections were performed with safety and precision following thorough skin cleaning.
Study Assessments
Baseline demographics, pre- and post-treatment photographs, and detailed records of injectable treatments were collected. Participants completed FACE-Q scales on the day of, before the procedure, and at the 4-week follow-up. Sum scores were converted into "Rasch" scores out of 100.
Statistical Analysis
Changes in Rasch scores were analyzed using a paired t-test with statistical significance at P < 0.05. Descriptive statistics, Pearson correlations, and independent-samples t-tests were used to evaluate the data.
Results and Discussion
Participants
Data from 28 participants showed significant improvements in FACE-Q scales, with psychological function scores increasing from 59.29 to 83.75, social function from 58.79 to 77.29, and appearance-related distress scores decreasing from 33.79 to 18.44.
Impact of Facial Aesthetic Units and FACE-Q Scores
No significant differences were found in FACE-Q scores between patients with different numbers of facial aesthetic units injected. This suggests that treating more facial units does not necessarily enhance quality of life.
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Safety
No ongoing adverse events were reported during the 4-week follow-up. Transient events included firmness, tenderness, and swelling at injection sites.
Conclusions
Injectable HA fillers significantly improved the psychological function, appearance-related distress, and social function of patients. The "whole-face" approach may not be as crucial as understanding specific patient motivations. More extensive studies are needed to confirm the benefits of HA fillers beyond treating wrinkles and folds.
Currently, most injectable studies focus on volumizing or correcting facial areas, neglecting patient-reported psychological and social outcomes. Hence, understanding individual patient needs over a blanket "whole-face" approach is vital for optimizing the benefits of Acido Hialuronico Fillers.