Clinical application of a new hyaluronic acid filler based on its rheological properties and the anatomical site of injection

Hyaluronic acid (HA) filler is the most commonly used filler for soft tissue augmentation. There are numerous commercially available HA fillers in the cosmetic market, and there are guidelines for each filler as determined by the manufacturing company. The successful use of injectable fillers requires an understanding of each option available so that the most appropriate form of hyaluronic acid may be selected for patients. The purpose of this study was to determine whether newly developed HA fillers are appropriate for forehead augmentation considering their rheological properties and the anatomical site of injection. The rheological properties of new HA fillers were assessed e.t.p.q. S100, S300, S500 (Zetema®). Comparing the rheological properties, the authors chose e.t.p.q. S300® for forehead augmentation. The filler was injected into the foreheads of 40 consecutive patients for esthetic purposes. e.t.p.q. S300® was determined to be an appropriate filler for the forehead. The injection procedure employed was considered to be easy and safe when applied to the preperiosteal layer using a cannula. None of the patients had complications such as vascular compromise, infections, granulomas, or migration. Understanding the physical properties of new fillers is necessary. As the preperiosteal layer of the forehead is an appropriate layer for the filler injection, physicians should consider injecting fillers with enough strength to withstand the shearing forces.