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Abstract Background Understanding the differences in soft tissue filler rheology and how these properties can impact clinical results is a fundamental concepts for any injector. This study aimed to assess the tissue integration characteristics of hyaluronic acid (HA) fillers manufactured with different technologies (Non‐Animal Stabilized HA HA‐N or Optimal Balance Technology HA‐O) using ultra‐high‐frequency ultrasound. Methods Twelve female participants with mild‐to‐moderate midface volume loss and temporal hollowing were enrolled and treated with HA‐N and/or HA‐O. Participants were seen at five visits (screening/baseline treatment, and Weeks 1 optional touch‐up, 4, 6, and 8 follow‐up visits). Ultrasound was used to evaluate the degree of product integration. Results On ultrasound, HA‐N presented with distinct borders, minimal tissue integration, and a capacity to displace tissues. Conversely, HA‐O tended to spread horizontally within the same tissue plane and integrated within tissues. The volumizing capacity of the HA‐O fillers was dependent on particle size. Conclusion HA‐N is suited for deep injections in areas such as the upper lateral cheek and under the muscle of the temporal region when a lifting effect is desired; HA‐O is best suited for subcutaneous injections, in areas of dynamic movement or for patients with thin skin; and can be injected subcutaneously or supraperiosteally when a volumizing effect is desired.
Nikolis et al. (Mon,) studied this question.