ABSTRACT Background In recent years, treatments using energy‐based devices (EBDs) aimed at skin quality improvement have become widely adopted. However, it has been pointed out that treatments using EBDs alone show limited durability of effects and variability in patient‐perceived improvements. Therefore, we evaluated skin quality improvement resulting from a combination therapy involving cross‐linked hyaluronic acid (CL‐HA) filler and EBD treatments tailored to patients' chief concerns. Objective To assess the efficacy and safety of combined CL‐HA filler and EBD therapies in treating facial skin quality improvement among Asian subjects. Methods In this prospective, evaluator‐blinded study, 18 participants aged 32–59 years with decreased skin elasticity, fine wrinkles, uneven texture, pore enlargement, pigmentation, and sagging were enrolled. CL‐HA filler (VYC‐12L) was injected intradermally into the entire face. One month later, according to each patient's primary concerns and symptoms, EBD treatment (either high intensity, high frequency parallel ultrasound beam PUB, picosecond alexandrite laser PSAL, and sequential monopolar bipolar pulsed radiofrequency SMBPRF) was administered to the entire face. Evaluations were conducted at three time points: baseline (T0), 4 weeks post‐CL‐HA injection (T1), and 8 weeks post‐EBD treatment (T2). Subjective assessment was performed using the FACE‐Q | Aesthetics—Satisfaction with Skin scale. Objective assessment was independently conducted by a dermatologist utilizing three‐dimensional image analysis and skin diagnostic imaging with the Global Aesthetic Improvement Scale (GAIS). Results All participants completed the study. Pairwise comparisons of the FACE‐Q skin satisfaction scores demonstrated statistically significant improvements at all time points: from T0 to T1 ( p < 0.05), from T0 to T2 ( p < 0.001), and from T1 to T2 ( p < 0.001). Objective assessment with the GAIS showed improvement in all cases: very much improved (2 cases), much improved (9 cases), improved (7 cases), no change (0 cases), and worsened (0 cases). Regarding safety, no severe adverse events were reported, and only minor transient post‐treatment reactions were observed. Conclusions The combination of CL‐HA filler and EBD represents a safe and effective therapeutic approach for enhancing facial skin quality in Asian subjects.
Oku et al. (Wed,) studied this question.