A combination treatment protocol using PEGylated hyaluronic acid hydrogel, non-ablative laser and hyaluronic acid skin boosters for rejuvenation of the perioral area

Abstract

  Personalized treatment with a combination of aesthetic protocols targets the different root causes, contributing to the patient’s aesthetic concerns and optimizes outcomes. This report presents the outcomes of a new protocol combining PEGylated hyaluronic acid (HA) hydrogel, non-ablative laser, and non-crosslinked HA skin booster to rejuvenate the perioral area within a single treatment session. This was a retrospective analysis of medical data from subjects who had undergone treatment with the perioral rejuvenation protocol at Kalea Clinic in the Netherlands. All subjects had been treated with the 3-step protocol involving: (i) injection with PEGylated HA hydrogel 24 mg/ml to contour and shape the lips; (ii) full-face treatment with a non-ablative, fractional diode laser with a wavelength of 1470 nm to smooth and tighten the skin; and (iii) full-face mesotherapy treatment with injection of non-crosslinked HA (18 mg/mL) with 0.01% calcium hydroxyapatite, glycine, and L-proline to improve skin quality. Follow-up visits took place at 6 (Visit 1) and 12 weeks (Visit 2), at which point physicians and patients assessed lip fullness and skin wrinkling on separate validated rating scales. Additional subjective assessment of treatment results was performed by both physicians and patients using the 5-point Global Aesthetic Improvement Scale (GAIS). Physician and patient satisfaction with treatment results was also assessed. Data were analyzed retrospectively for 14 female subjects with a mean age of 39.1 years. At baseline, lip fullness was rated as moderate by 71% of physicians and 64% of patients. At visit 2, 71% of lips were rated as thick and 14% as full by both physicians and patients. The mean skin wrinkle score improved from 1.30 (visible wrinkles with clear indentation) at baseline to 0.79 (fine wrinkle, slight indentation) at Visit 2. Mean GAIS scores for both physicians and patients indicated appearance was ‘improved’ at Visit 1 (mean scores of 3.0 and 2.7, respectively) and ‘much improved’ at Visit 2 (mean scores of 2.4 and 2.3, respectively). All treatments in the protocol were well tolerated. Both physicians and patients were satisfied with the combination protocol, and all patients reported they would be ‘likely’ or ‘very likely’ to recommend it. The combination of three different treatment modalities (PEGylated HA hydrogel, non-ablative laser, and HA mesotherapy) in a single treatment session demonstrated effectiveness in rejuvenating lips and perioral area. The complementary treatments were tailored to the individual for a natural-looking effect.