D-LOUNGE Hydro-lifting Procedure

 

Formula

1. Elravie Balance(Huons)
2. Restylane Vital(Galderma)
3. Innotox(Medytox) or Placentex(Mastelli)

I choose from a various formulae to customize the treatment for the patient’s skin type. I generally use Elravie Balance as a non-crosslinked HA, and Restylane Vital as a cross-linked HA. Depending on the skin condition, Innotox or PDRN is combined.

 

Methods

1. Derma Shine Balance or Vital Injector2
2. JBP nano-needle

 I primarily choose between two injectors; Derma Shine Balance and Vital Injector 2, depending on the proportion of the solution, dose, and the patient’s skin conditions. 

In the eye and mouth areas where it is not suitable to use an injector, I use JBP nano-needle in manual injection.

 

Indications

1. Fine wrinkle(periorbital & perioral)
2. Sensitive skin(xerotic eczema, seborrheic dermatitis, etc.)
3. Acne and acne scar

The HA injection effectively improves the skin tone, texture, fine lines and pores. It also helps a healthy balance between the water and oil contents of the skin and is particularly beneficial in dry and acne skin types. It can be combined with different fractional Laser therapies used for scar removal.

 

 Adverse Reactions

1. Bruise
2. Secondary infection(bacterial and viral)
3. Prolonging skin nodule

Bruising is the most serious complication and is particularly more frequent in elderly patients who are taking aspirin and other blood-thinning medications. To prevent this, tranexamic acid can be used. As the injection site is vulnerable to secondary infection through the needle puncture, instruct the patient to avoid using the sauna or pool for a week after treatment. Embossing can continue as a crosslinked HA is also used but with my formulation, embossing is resolved within 48 hours of treatment.

 

Procedures

1. Skin Anesthesia
2. Skin Preparation
3. Hydrolifting procedure
4. Aesthetic procedure

A topical anesthetic cream is applied 40 minutes before treatment. I find 9.6% lidocaine more effective than 2.5% lidocaine + 2.5% prilocaine.

As the procedure is somewhat invasive(needle puncture), pre-injection sterilization of the skin is carried out before treatment and again during the procedure after one side of the face is treated. Downtime can be minimized with adequate pre-treatment and post-treatment care. I provide cryo-eletroporation, low level Laser therapy, and Rubber-MASK, etc. after treatment to soothe the skin.

Let us take a look at a few cases that received Water Gloss Injection at my practice.

 

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Case1:

Patient condition: 33/F Dry skin, mild erythema, fine wrinkle

Immediately after treatment: Clinical photographs taken immediately after treatment show several needle puncture marks, redness and edema. Downtime can be minimized when the doctor puts effort into preventing it.

One week after treatment:

IGA(Investigator’s Global Assessment)

No drastic improvements are observed as the patient is young and has only mild skin problems. The forehead and both cheek erythema has greatly subsided.  

PGA(Patient’s Global Assessment)

The skin feels relaxed, smooth and hydrated. Make-up does not get as cakey as before and the skin tone and texture have improved.

 

Profile of the face before and after Water Gloss Injection.

 

Figure 1. Before and after Water Gloss Injection.

 

References

1. Longas MO, Russell CS, He XY. Evidence for structural changes in dermatan sulfate and hyaluronic acid with aging. Carbohydr Res 1987;159(1):127-36.
2. Sakai S, Yasuda R, Sayo T, Ishikawa O, Inoue S. Hyaluronan exists in the normal stratum corneum. J Invest Dermatol 2000;114:1184-87.
3. C Laurent T. Hyaluronan Research in Uppsala Ups J Med Sci 2007;112(2):123-42.
4. Stern R. Hyaluronan catabolism: a new metabolic pathway. Eur J Cell Biol 2004;83(7):317-25.
5. Wang F, Garza LA, Kang S, Varani J, Orringer JS, et.al. In vivo stimulation of de novo collagen production caused by cross-linked hyaluronic acid dermal filler injections in photodamaged human skin. Arch Dermatol 2007;143(2):155-63.
6. Kerscher M, Bayrhammer J, Reuther T. Rejuvenating influence of a stabilized hyaluronic acid-based gel of nonanimal origin on facial skin aging. Dermatol Surg 2008;34:720-6
7. Kenner JR. Hyaluronic acid filler and botulinum Neurotoxin delivered simultaneously in the same syringe for effective and convenient combination aesthetic rejuvenation therapy. J Drugs Dermatol 2010;9(9):1135-8.
8. Môle B. Scratched faces: treatment of dynamic facial wrinkles through the simultaneous combined use of botulinium toxin A and hyaluronic acid. Ann Chir Plast Esthet 2012;57(3):194-201.

-To be continued-