ReviewJournal of cosmetic dermatology2025
Decomposition and Changes in In Vivo Post-HA Filler Injection: A Review.
Review in Journal of cosmetic dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- The PATH Protocol for Integrated Facial Rejuvenation: A Preliminary Three-Patient Case Report Series and Narrative Review of the Literature.Reports (MDPI) · 2026Article
- Article
- Changes of Tissue Reactions on Various HA Filler Under Immune Stress Status: An In Vivo Study.Aesthetic plastic surgery · 2026Article
- Crosslinked hyaluronic acid-doped polypyrrole: Stable, nonbiofouling implantable bioelectrodes for in vivo signal recording.Materials today. Bio · 2026Article
- From permeation enhancer to therapeutic enabler: Advances, applications, and translational perspectives in hyaluronidase-based drug delivery.Materials today. Bio · 2026Review
- Clinical safety of a low-modification hyaluronic acid filler (MoD 2%) for facial rejuvenation.JPRAS open · 2026Article
- Comprehensive Analysis of Free BDPE Content in Commercial Hyaluronic Acid Fillers: Implications for Safety Assessment and Regulatory Standards.Journal of cosmetic dermatology · 2026Article
- Facial Overfilled Syndrome: A Narrative Clinical Review.Clinical, cosmetic and investigational dermatology · 2026Review
- Effectiveness and Safety of Belotero Intense ± Lidocaine for the Correction of Nasolabial Folds, Marionette Lines, and Lip Volume Enhancement: A Randomized Post-Market Clinical Follow-Up Study.Aesthetic surgery journal. Open forum · 2026Article
- Comparative Evaluation of the Biodegradability and Biocompatibility of Agarose Gel and Hyaluronic Acid Filler.Aesthetic plastic surgery · 2025Article
- Review
- A Scientific Framework for Comparing Hyaluronic Acid Filler Crosslinking Technologies.Gels (Basel, Switzerland) · 2025Article
- Article
- Quantitative Assessment of Polydioxanone Microsphere Fillers for Nasolabial Fold Correction: A Comparative Study.In vivo (Athens, Greece)Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyaluronic acid (HA) fillers are widely used in aesthetic medicine, but their in vivo behavior and long-term effects are not fully understood.
aimsTo review the decomposition and changes occurring in the body following HA filler injections, focusing on crosslinking agents, degradation processes, and tissue responses.
methodsThis review analyzed oxidative and enzymatic degradation processes of HA fillers, evaluated the impact of 1,4-Butanediol Diglycidyl Ether (BDDE) crosslinking, and examined histological changes post-injection.
resultsUncrosslinked HA degrades rapidly due to endogenous hyaluronidase, while crosslinked HA undergoes slower degradation via free radicals and hyaluronidase. Complete cross-linking (C-MoD) showed better durability compared to partially cross-linked BDDE (P-MoD). The concept of modification efficiency (MoE) was proposed to optimize filler safety and viscoelastic properties. Histological analysis revealed collagen capsule formation and autologous tissue replacement, affecting long-term outcomes. The degree of chemical modification (MoD) influences filler durability and safety, with concerns raised about potential delayed immune reactions from accumulated pendent BDDE.
conclusionsClinicians should consider injection site, tissue conditions, and filler properties for safe and effective HA filler use. Emphasizing thorough BDDE removal and optimal crosslinking can enhance treatment safety and efficacy. The balance between achieving desired viscoelastic properties and minimizing potential risks is crucial. Future studies should include diverse ethnic groups to validate findings and further explore long-term tissue responses to HA fillers.
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