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      Safety and Efficacy of an Injectable Solution Enriched With Sodium Hyaluronate, Amino Acids, and Peptides in Relation to Superficial Facial Connective Tissues (Dermis and Retinacular Cutis)

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          ABSTRACT

          Background

          Skin aging research often focuses on the dermis, overlooking the significance of the retinacular cutis (RC) in aging. This study aimed to investigate the efficacy, safety, and effect of an injectable solution containing hyaluronic acid, amino acids, and peptides, on facial sagging and laxity by targeting the RC.

          Methods

          This single‐center observational study recruited 28 female volunteers aged 25–65 years. The participants received four monthly injections of the studied solution. Objective measures included skin hydration, elasticity, color, thickness, collagen density evaluated via DermaLab Combo and high‐resolution ultrasound imaging. Subjective measures included participant satisfaction evaluated using the Global Aesthetic Improvement Scale (GAIS). Adverse effects were monitored throughout the study period.

          Results

          Significant improvements were observed in skin hydration, elasticity, and collagen density after treatment. Hydration increased by 25.9% at T1 (30 days after last session), sustaining a 15.9% increase at T2 (120 days after last session). Elasticity improved by 29.2% at T1 and 20.7% at T2. Collagen density increased by 20.27% at T1 and 16.71% at T2. Self‐reported GAIS scores showed consistent increases. Adverse effects were minimal and included only transient ecchymosis and mild pain.

          Conclusion

          Injections of the solution had a substantial hydrating effect, enhanced elasticity, and increased collagen density in the RC and dermis. Results persisted at the 120‐day follow‐up, indicating sustained benefits. Hence, this injectable solution may offer a safe and effective non‐invasive treatment option for improving skin laxity and sagging, targeting the RC and other deep connective tissue such as retaining ligaments.

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          Most cited references18

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          Mechanisms of Photoaging and Chronological Skin Aging

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            Mechanisms and treatments of photoaging

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              The Facial Aging Process From the “Inside Out”

              The normal course of aging alters the harmonious, symmetrical, and balanced facial features found in youth, not only impacting physical attractiveness but also influencing self-esteem and causing miscommunication of affect based on facial miscues. With this evidence-based paper, the authors aim to provide a comprehensive overview of the latest research on the etiology and progression of facial aging by explaining the aging process from the “inside out,” that is, from the bony platform to the skin envelope. A general overview of the changes occurring within each of the main layers of the facial anatomy is presented, including facial skeleton remodeling, fat pad atrophy or repositioning, changes in muscle tone and thickness, and weakening and thinning of the skin. This is followed by an in-depth analysis of specific aging regions by facial thirds (upper, middle, and lower thirds). This review may help aesthetic physicians in the interpretation of the aging process and in prioritizing and rationalizing treatment decisions to establish harmonious facial balance in younger patients or to restore balance lost with age in older patients. El curso normal del envejecimiento altera las características faciales armoniosas, simétricas y equilibradas que se encuentran en la juventud, lo que no sólo afecta el atractivo físico, sino que también influye en la autoestima y causa una comunicación equivocada del afecto con base en pistas faciales confundidas. Con este paper basado en evidencias, los autores buscan ofrecer una descripción integral de las más recientes investigaciones sobre la etiología y la progresión del envejecimiento facial explicando el proceso del envejecimiento de “dentro hacia fuera”, es decir, de la plataforma ósea a la envoltura de la piel. Se presenta una descripción general de los cambios que ocurren dentro de cada una de las capas principales de la anatomía facial, entre ellos el remodelado del esqueleto facial, la atrofia o reposicionamiento de las capas de grasa, los cambios en el tono y grosor de los músculos, y el debilitamiento y adelgazamiento de la piel. A esto le sigue un análisis a fondo de las regiones específicas del envejecimiento por tercios faciales (tercios superior, medio e inferior). Esta revisión puede ayudar a los médicos estéticos en la interpretación del proceso de envejecimiento y en la priorización y racionalización de las decisiones de tratamiento para establecer un equilibrio facial armonioso en pacientes más jóvenes o para restaurar el equilibrio perdido con la edad en pacientes mayores.
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                Author and article information

                Contributors
                evgeniya.shelemba@gmail.com
                Journal
                J Cosmet Dermatol
                J Cosmet Dermatol
                10.1111/(ISSN)1473-2165
                JOCD
                Journal of Cosmetic Dermatology
                John Wiley and Sons Inc. (Hoboken )
                1473-2130
                1473-2165
                15 September 2024
                January 2025
                : 24
                : 1 ( doiID: 10.1111/jocd.v24.1 )
                : e16586
                Affiliations
                [ 1 ] P.L. Shypuk National Medical Academy of Post‐Graduate Education Kyiv Ukraine
                [ 2 ] Innovaesthetic Kyiv Ukraine
                [ 3 ] Private Practice London UK
                [ 4 ] Private Practice Paris France
                Author notes
                [*] [* ] Correspondence:

                Evgeniya Shelemba ( evgeniya.shelemba@ 123456gmail.com )

                Author information
                https://orcid.org/0000-0002-5765-406X
                Article
                JOCD16586 JCD-03-2024-219.R2
                10.1111/jocd.16586
                11743070
                39279301
                f3d606f1-fd40-4760-b70a-7ae8ce5dae44
                © 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 August 2024
                : 02 March 2024
                : 03 September 2024
                Page count
                Figures: 14, Tables: 1, Pages: 12, Words: 4200
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                January 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.2 mode:remove_FC converted:19.01.2025

                Dermatology
                amino acids,collagen,connective tissue,facial ligaments,ha,peptides,retinacular cutis
                Dermatology
                amino acids, collagen, connective tissue, facial ligaments, ha, peptides, retinacular cutis

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