Evidence map›Paper›PMID 41437808›Full record

ArticleJournal of cosmetic dermatology2026

Understanding Clinical and Biophysical Differences Between Non-Cross-Linked and Cross-Linked Hyaluronic Acid Dermal Fillers.

Silvia Fontenete, Carlos Bravo, Michael Alfertshofer, Sebastian Cotofana

Abstract readComparative Study
In one paragraph

Article in Journal of cosmetic dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Silvia FonteneteMedical Department, BioScience GmbH, Madrid, Spain.ORCID https://orcid.org/0000-0003-1972-6349
Carlos BravoPrivate Practice, San José, Costa Rica.
Michael AlfertshoferDepartment of Oromaxillofacial Surgery, Ludwig-Maximilians-University Munich, Munich, Germany.ORCID https://orcid.org/0000-0002-4892-2376
Sebastian CotofanaDepartment of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-7210-6566

Funding

BioScience GmBH
6 · The paper itself

Abstract

backgroundThe rising popularity of injectable soft-tissue fillers in esthetic medicine is driven by their potential to provide facial rejuvenation through minimally invasive techniques. Hyaluronic acid (HA)-based fillers exhibit distinct biophysical characteristics, including rheological properties which are critical for their behavior under mechanical stress. This study aims to compare the viscoelastic properties of commercially available crosslinked (CFs) and non-crosslinked HA fillers (NCFs).

methodsA total of 28 commercially available HA fillers, including both non-cross-linked (n = 3) and cross-linked types (n = 25), were investigated for their rheological properties. Rheological parameters such as storage modulus (G'), loss modulus (G″), loss tangent (tan δ), and complex modulus (G*) were measured over a frequency range of 0.1-10 Hz.

resultsNCFs showed greater variation in G' with a mean of 3263% [range: 1767-4177] compared to crosslinked fillers with 247.60% [range: 85-720]. The calculated difference between the change in percent of CFs versus NCFs was 3016% (755) for G' with p < 0.001, whereas it was 926% (498) for G″ with p < 0.001, and it was -154% (25.8) for tan-delta with p < 0.001, and 966% (147) for G* with p < 0.001.

conclusionsNCFs and CFs exhibit distinct rheological profiles, with NCFs demonstrating a greater change in their initial rheologic properties when exposed to mechanical stress. This specific biophysical behavior (increase in stiffness and viscosity) predisposes NCFs for dermal structural support with the respective subdermal applications, whereas CFs seem to be more suitable for deep soft tissue injections, offering volumization.

Indexed as

Cosmetic TechniquesDermal FillersHyaluronic AcidCross-Linking ReagentsElasticityHumansMaterials TestingRejuvenationRheologyStress, MechanicalViscosityCross-Linking ReagentsDermal FillersHyaluronic Acidcross‐linkinghyaluronic acidnon‐Newtonian fluidsrheologysoft tissue dermal filler

Identifiers

PMID41437808
PMCPMC12728490

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.