Skin Aging
Skin aging and facial age‐related morphological changes are usually related to the loss of skin elasticity due to intrinsic (e.g., genetic) and extrinsic (e.g., sun exposure, smoke, and lifestyle) factors. Morphological changes occurring during aging lead to a loss in facial volume and the formation of wrinkles. These appearance modifications can cause some people distress and have a marked impact on social behavior and relationships, leading to an overall increase in aaesthetic procedures. Increasing evidence suggests that adipose tissue can represent a suitable target in aaesthetic medicine. Fat compartments in the face can be anatomically categorized as superficial (e.g., nasolabial fat, superficial medial cheek fat, and intraorbital fat) or deep (e.g., buccal fat, deep medial cheek fat, and medial and lateral suborbicularis oculi fat). The fat compartment plays an important role in midfacial aging. A decrease in the fat compartment of the face has been well‐documented with age. Moreover, a decrease in the mean size of adipocytes has been found in the deep cheek fat compartment compared to the superficial one in elderly subjects compared with young people. For these reasons, several treatment options for facial rejuvenation have been considered in the last few years involving fat compartments, including lipotransfer.
Hyaluronic acid
Hyaluronic acid (HA) treatments are well‐known and used for facial rejuvenation and aesthetic procedures due to the ability of this polymer to reduce skin aging and wrinkle formation. As a result of its specific biochemical and physical characteristics, HA is one of the most widely used components of fillers worldwide, and can be administered in different formulations, depending on HA molecular weight, composition, and concentration. However, several limitations are known for HA fillers, such as the use of additional chemical reagents, its short half‐life, and its concentration limit. Patented NAHYCO® technology enabled the delivery of a high concentration of HA. Several studies demonstrated that HCC had a longer resistance to degradation than traditional HA treatments and showed efficacy in ameliorating aesthetic defects due to wrinkles. HCC also proved effective for sustaining the vitality of human adipose stem cells and adipocytes and maintaining the fat compartment. A new formulation of HCC, Profhilo Structura®, has been developed for adipose tissue restoration. Profhilo Structura® contains a higher concentration of HA (45 mg of low molecular weight HA plus 45 mg of high molecular weight HA in a 2 mL injection) and different rheological properties compared with the previously commercialized Profhilo ® (32 mg of low molecular weight HA plus 32 mg of high molecular weight HA in a 2 mL injection) product.
Figure 1. Natural Ageing Process
As a result of these properties, Profhilo Structura® is a product designed for restoring face adipose tissue compartments. Hyaluronic acid (HA)‐based injections are used worldwide to improve skin defects associated with aging and ultraviolet light/environmental exposure. HA formulations developed according to molecular weight or with additional components, for example, cross‐linking reagents, are limited by their low biological activity and concentration limit. NAHYCO™ technology has enabled the production of hybrid cooperative complexes (HCCs) of low and high molecular weight HA. Developed for injection into the fat compartments of the face and previously demonstrating potential benefits for adipose tissue restoration, Profhilo Structura® is a new 2 mL HCC formulation comprising low molecular weight HA (45mg/mL) and high molecular weight HA (45 mg/mL). To evaluate the efficacy and tolerability of Profhilo Structura® to restore adipose tissue compartments in the lateral cheek fat compartment. Fifty healthy subjects enrolled received two injections, 1 month apart, and were evaluated 3 months posttreatment. Investigators performed clinical evaluations (Facial Volume Loss Scale [FVLS] and Wrinkle Severity Rating Scale [WSRS]) at different time points.
Figure 2. PROFHILO® EFFECT
Subjects also completed self‐evaluation assessments following treatment. A significant improvement in FVLS and WSRS clinical scores after the first treatment was observed; treatment benefit was maintained 3 months after treatment completion and confirmed by subject self‐assessment. Most participants reported an improvement, particularly a marked reduction of wrinkles and increased skin firmness. No serious adverse events were reported, confirming the excellent safety profile of HCC injectable devices. HA has therefore become a well-known dermal agent, shown to promote collagen synthesis, stimulate fibroblast proliferation, and correct skin defects.
PROFHILO®
Skin aging and facial age‐related morphological changes are usually related to the loss of skin elasticity due to intrinsic (e.g., genetic) and extrinsic (e.g., sun exposure, smoke, and lifestyle) factors. Morphological changes occurring during aging lead to a loss in facial volume and the formation of wrinkles. These appearance modifications can cause some people distress and have a marked impact on social behavior and relationships, leading to an overall increase in aaesthetic procedures. Increasing evidence suggests that adipose tissue can represent a suitable target in aaesthetic medicine. Fat compartments in the face can be anatomically categorized as superficial (e.g., nasolabial fat, superficial medial cheek fat, and intraorbital fat) or deep (e.g., buccal fat, deep medial cheek fat, and medial and lateral suborbicularis oculi fat). The fat compartment plays an important role in midfacial aging. A decrease in the fat compartment of the face has been well‐documented with age. Moreover, a decrease in the mean size of adipocytes has been found in the deep cheek fat compartment compared to the superficial one in elderly subjects compared with young people. For these reasons, several treatment options for facial rejuvenation have been considered in the last few years involving fat compartments, including lipotransfer.
- High HA concentration (64 mg/2 mL)
- Low viscosity
- High manageability
- No BDDE19 or other chemical agents
- Optimal tissue diffusion
- Low inflammatory response
Figure 2. These 5 points identify the 5 anatomically receptive areas of the face with an absence of large vessels and nerve branches, therefore, minimizing the risks while maximizing the diffusion of the product in the malar and sub-malar areas.
In vitro and clinical studies
. In vitro analysis of the effects on wound healing of high-and low-molecular weight chains of hyaluronan and their hybrid H-HA/L-HA complexes 2015
. Hyaluronan Hybrid Cooperative Complexes as a Novel Frontier for Cellular Bioprocesses Re-Activation 2016
. Efficacy and tolerance of an injectable medical device containing stable hybrid cooperative complexes of high- and low-molecular-weight hyaluronic acid: a monocentric 16 weeks open-label evaluation 2016
.Hybrid Complexes of High and Low Molecular Weight Hyaluronans Highly Enhance HASCs Differentiation: Implication for Facial Bioremodelling 2017
. Efficacy and tolerability of ProfhiloR Structura intended to restore lateral cheek fat compartment: An observational pilot study 2024
. Intradermal Injection of Hybrid Complexes of High- and Low-Molecular-Weight Hyaluronan: Where Do We Stand and Where Are We Headed in
Regenerative Medicine? 2024
Figure 4. PROFHILO a) Tightening Effect (left) b) Doctors and Patients Satisfaction
Figure 5. PROFHILO®’s Improved Hydration and Elasticity
How to use
The Bio Aesthetic Points
- Improves Skin Tone and Texture Improves Skin Firmness.
- Deeply Hydrates the Skin Improves Line and Wrinkle.
- Stimulates Collagen and Elastin Flabby, dry skin.
- Expressed age-related, mimic wrinkles Scars and post-acne.
- Pigmented spots Gravity ptosis (omitting of soft tissues of the face)
References
Sparavigna A, Grimolizzi F, Cigni C, Lualdi R, Bellia G. Efficacy and tolerability of Profhilo® Structura intended to restore lateral cheek fat compartment: An observational pilot study. Health Sci Rep. 2024 Jan 21;7(1):e1743. doi: 10.1002/hsr2.1743.
Reilly, DM.; Lozano J. Skin collagen through the lifestages: importance for skin health and beauty. Plast. Aesthet. Res. 2021, 8, 2. http://dx.doi.org/10.20517/2347-9264.2020.153.
Wang Z, Man MQ, Li T, Elias PM, Mauro TM. Aging-associated alterations in epidermal function and their clinical significance. Aging (Albany NY). 2020 27;12(6):5551-5565. doi: 10.18632/aging.102946.
Agolli, Enis et al., Hybrid cooperative complexes of high and low molecular weight hyaluronans (Profhilo®): review of the literature and
presentation of the VisionHA project. Esperienze Dermatologiche. 2018. 20. 5-14. 10.23736/S1128-9155.18.00470-3.
Laurino C, Palmieri B, Coacci A. Efficacy, Safety, and Tolerance of a New Injection Technique for High- and Low-Molecular-Weight Hyaluronic Acid Hybrid Complexes. Eplasty. 2015 8;15: e46.