Hyaluronic acid is a natural polysaccharide of our skin extracellular matrix.

It is the primary ingredient which provides our skin with juvenile status and the firmness of young ages. It has got the capacity to retain the necessary water quantity in the tissues.

As time goes by, skin’s hyaluronic acid content is reduced, the skin appears drawn and aged, fine and deeper wrinkles appear.

Hyaluronic acid is identical in all animal species and microbes. Taking advantage of this fact, we can produce hyaluronic acid by bacterial fermentation of Streptococcus equi. This produced, pure hyaluronic acid, would disappear after just a few days from our skin, if the glycosaminoglycan chains crosslinking procedure did not ensue. This crosslinking stabilizes the hyaluronic acid so as to remain where it is injected, for several months. The crosslinking extent is pivotal for the hyaluronic acid ultimate composition, so as to be potential to have more hyaluronic acid types for several injection anatomic levels. The aforementioned procedure of hyaluronic acid production and process is called NASHA (Non-Animal Stabilized Hyaluronic Acid).

Hyaluronic acid contains protein elements which could cause topical reaction as an inflammation or granulation. We should be aware of the fact that after the period of 1999-2000, based on the substantial progress in the hyaluronic process procedure, they are considered very safe materials.

It is no coincidence, that after 2000, hyaluronic acid gradually started to get approval from one of the strictest organizations (U.S FDA-United States Food and Drug Administration) for their use in treating wrinkles and face volume replacement.

Hyaluronic acid is used to correct several problems such as:

• lip enhancement (improvement of lip line definition and/or enlargement of one or both lips)
• mouth corners ptosis
• upper lip vertical rhytids
• nasolabial folds
• marionette lines
• horizontal labiomental groove
• glabellar lines
• horizontal forehead wrinkles
• facial lipodystrophy or atrophic losses
• eyebrows ptosis
• lacrimal grooves under the eyes
• volume deficit at the cheekbones area
• fine lines and dehydrated skin
• acne atrophic scars
• nose imperfections
• neck and décolleté lines

With hyaluronic treatment, wrinkles and grooves are smoothened, face contour is highlighted and lost volume is refilled.

Additionally, injectable hyaluronic activates collagen production and promotes hyaluronic acid composition by organism itself, an action which is cumulative.

We use more types of hyaluronic, depending on the needs of the treated area.

The results are immediately obvious and finalized in the next 2 weeks.

The results duration vary from person to person, even on the same person from area to area and generally lasts from 6 to more than 2 years under conditions.

We ought to know that areas with higher mobility, as lips and around them wrinkles, show faster hyaluronic acid absorption.

On the contrary, lower mobility areas as glabella retain hyaluronic for a longer period. When Botox treatment precedes in this area, hyaluronic absorption is delayed for even more time.

How does hyaluronic acid work?

Hyaluronic acid belongs to the category of ”volumateurs”.It works by filling the wrinkles and attracting water molecules. As time goes by hyaluronic starts being absorbed, more and more water is concentrated in the area and compounds with the remaining hyaluronic, preserving the result for a longer period.

Which is the most proper age for someone to start the hyaluronic acid therapies?

Even though the answer to this question, depends on the needs of our skin and our face tissues quality, the age of 25-30 is considered to be the best period to start hyaluronic acid. Let’s not forget that the results are better when we are careful and keep our skin in good condition from early ages, rather than trying to reconstruct a tired and aged skin.

How is the treatment accomplished?

After having carefully examined face anatomy and singularities, we prepare the skin and we inject hyaluronic in the intended anatomic levels. The injection is done through a very fine needle to minimize discomfort. The whole procedure lasts almost 30 minutes.

How is the face right after treatment?

The result is immediately obvious. Very slight red marks may appear at the needle entrance spots. Those fade away promptly and we can return to our daily routine with no problem. In rare cases, a temporary slight ecchymosis may appear, which is covered with make-up.

Is hyaluronic acid a popular therapy?

It is the second more frequent non-invasive therapy worldwide. In 2015, almost 2 million hyaluronic acid treatments were applied in the USA.

How much downtime can I expect?

The hyaluronic acid therapy is characterized as ”lunch break treatment”, generally, after the treatment, we can return to our work, with no evident therapy marks. We should though, for the following 3-4 days, avoid intense massage on the injected area. This is the demanded time for the hyaluronic, to be stabilized in its place. It would also be wise to avoid extreme physical exercise.

Is this therapy suitable for me?

Hyaluronic acid therapy is suitable for women and men who are stressed with the wrinkles around lips, the forehead wrinkles as well as the wrinkles between eyebrows and they wish to look younger and more relaxed.

I worry whether my face expression changes or be disfigured!

We should not worry about such a thing. The Plastic Surgeon has excellent knowledge on face anatomy and of course the proper training.

How will I look after hyaluronic acid therapy?

After treatment we look refreshed, more relaxed and with a better skin quality.

Is there wrinkles prevention with hyaluronic?

Of course! Hyaluronic works as a constructive component supporting our skin. It creates a protective environment for the collagen and elastic fibers structure maintenance.

What other therapy can it be combined with?

Hyaluronic can be combined with a great number of therapies, such as diamond microdermabrasion, mesotherapy, Botox, autologous therapy PRP, threads, but also to complete the result of a blepharoplasty or a face lifting.

Can hyaluronic acid replace the aesthetic surgeries?

Hyaluronic acts in a different way and it cannot replace aesthetic surgeries. Respectively, cosmetic surgeries cannot replace hyaluronic acid therapy, even though they can reduce the demanding filler quantity.

Is hyaluronic acid a safe therapy?

This therapy has been used for treating wrinkles to millions of patients all over the world. There are a lot of studies proving this therapy’s safety.

How long does hyaluronic acid last?

The duration of the result varies from person to person, even at the same person from area to area and it generally lasts from 6 months up to more than 2 years under particular circumstances. Apart from others, a very important factor is the quality of the product.

What happens after consecutive hyaluronic therapies?

It seems that the regular therapy increases the duration of the result.

What are the possible problems or complications after the hyaluronic acid therapy?

Generally minor red marks, swellings or ecchymosis may appear. Special problems are asymmetries, protuberances, herpes labialis exacerbation, dermal necrosis, hypertrophic scarring at the point where the needle goes in, granuloma formation and delayed hypersensitivity reaction. In bibliography, visual disturbance individual incidents have been described (in 2012, Lazzeri et al. in a bibliography review article, he described three visual disturbance incidents after hyaluronic injection).We should know that these complications are generally rare and we should trust specialized Plastic Surgeon, who owes face anatomy excellent knowledge and appropriate training.

What is the difference between hyaluronic acid and Botox?

Hyaluronic acid fills the wrinkles and restores the lost volume. It has no action on the underlying muscles. Botox treats the wrinkles by relaxing the regional muscles. Very often these both therapies can be combined.

I am pregnant. Can I have hyaluronic acid therapy?

There are no sufficient studies concerning the safety of this therapy in such situations. Consequently, therapies with hyaluronic acid should not be done neither to pregnant nor breastfeeding mothers.

From times to times I had cold sores. Can I have hyaluronic acid?

The therapy with hyaluronic is possible in such cases. We should know though, that there is a chance, even though slight, of herpes infection recurrence, after any injectable or laser therapy in perioral area. In some cases, taking antivirals is recommended (Valtrex).