Hyaluronic acid injections: all the answers to all the questions

Hyaluronic acid injections used in modern cosmetology, that is, intradermal injections of hyaluronic acid, are considered to be a fairly effective way to partially get rid of some appearance defects, for example, wrinkles on the face.

But before deciding on such a procedure, it will be useful to know: what is hyaluronic acid, how does it smooth the skin, are there any contraindications, what will the face be like after the procedure? We will try to answer all your questions, including: are hyaluronic acid injections harmful?

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Hyaluronic acid injections - to maintain the extracellular matrix

The principle of the effect of Kraosta injections on the skin is compensatory, that is, the insufficient amount of endogenous hyaluronic acid synthesized by fibroblasts is replenished.

The connective tissue in our body has an interstitial (extracellular) space - the so-called extracellular matrix (Latin matrix - basis), which is a collection of extracellular molecules that provide structural and biochemical support for the surrounding cells. This basis consists of complex proteins - glycoproteins (collagen, elastin, fibronectin, etc.), proteoglycans (linear carbohydrate-protein biopolymers), as well as linear polysaccharides with a negative charge - glycosaminoglycans - associated with the protein part of proteoglycans.

Glycosaminoglycans, along with chondroitin sulfates and keratan sulfates (which are part of cartilage tissue, synovial fluid of joints and tissue of the cornea of the eye), also include hyaluronic acid (or hyaluronan).

Hyaluronic acid is a high-molecular acidic carbohydrate in the form of a specific polysaccharide, which is located on the basal membranes of cells and moves during the biosynthesis process. Unfortunately, this substance is subject to biological degradation: for example, in skin tissues, its half-life does not exceed 24 hours.

The hyaluronic acid molecule, which has a very high molecular weight, is one of the most hydrophilic (water-loving) molecules in nature and can bind water molecules in a volume exceeding its own weight by almost a thousand times. Located in the extracellular matrix, it provides tissues with the ability to resist compression: it absorbs a significant amount of water, takes on a gel-like form and provides counteracting swelling force. In addition, it ensures the free passage of nutrients.

Due to its high viscosity, hyaluronic acid, which is part of the cartilage tissue and synovial fluid of the periarticular capsules, protects our joints from excessive wear. Hyaluronic acid is also present in tendons and ligaments, and is contained in the vitreous body of the eye (and maintains normal intraocular pressure).

In the skin, it is most abundant in the basal layer of the epidermis, where proliferating keratinocytes are located, as well as between the fibers of elastin and collagen. It is also present in the cells of the stratum corneum. Hyaluronic acid maintains an optimal moisture level in the skin by binding water, thereby preventing elastin and collagen, which support the structure of the skin, from “drying out”.

Over time, that is, with age, the natural synthesis of hyaluronic acid gradually decreases, the skin retains less water and becomes dry. Beauty injections help the extracellular matrix of the skin to maintain a sufficient level of moisture.

By the way, the synthesis of hyaluronic acid almost completely stops with high doses of ultraviolet radiation, which is why excessive tanning dries and ages the skin...

Hyaluronic acid injections for the face

Today, no one gives injections of hyaluronic acid for the face using the substance that was first obtained from chicken combs and bovine cartilage.

Currently, injections of youth are made exclusively with its synthetic analogues, which are produced using modern biotechnology. This is sodium hyaluronate - sodium salt of hyaluronic acid. In addition, pharmaceutical companies produce drugs in the form of gel fillers based on this substance. At the same time, biochemists have learned to reduce the length of the polysaccharide chain and its molecular weight by means of "polymer cross-linking" - for better penetration into the skin structures and slowing down the process of its biological decay, that is, prolonged positive action. Such hyaluronic acid is called structurally modified or stabilized.

The most well-known hyaluronic acid preparations for cosmetology purposes are: Juvederm (USA), Restylane and Restylane-L (USA), Esthelis (Switzerland), Elevess (USA), Princess (Austria), Hylaform (USA), Surgiderm (France), Yvoire (France), Teosyal (Switzerland), Belotero (Switzerland), Perlane (USA), Puragen (UK). Some of these preparations contain anesthetics.

Hyaluronic acid injections for the face can increase the firmness and elasticity of the skin, smooth out expression wrinkles and, naturally, improve the appearance. This method is called "biorevitalization".

Beauty injections in cosmetology are also called "hyaluronic mesotherapy", taking the main principle of this method: intradermal administration of drugs in small doses. Although in this case it is not a treatment, but an injection method of correcting the face and its contours: wrinkles in the nasolabial folds, on the forehead, chin, around the eyes. Gel-like preparations with sodium hyaluronate (the so-called fillers) are injected shallowly into the skin in the right places.

The face after hyaluronic acid injections will look younger in a week or two, and the skin will be more elastic. But it should be borne in mind that correction using hyaluronic acid gives a temporary effect, since all preparations with this substance are absorbed over time. Thus, the rejuvenating effect of biorevitalization lasts no more than six months (or even less), and the maximum duration is 9-12 months. Therefore, the desire to look younger and more attractive will have to be supported by periodic repetition of this procedure.

Most women get hyaluronic acid injections into their lips to make them plumper. The skin on the lips consists mainly of connective tissue and its components - hyaluronic acid and collagen, which give the lips their shape and roundness. Hyaluronic acid, by binding water, creates a gel-like liquid that moisturizes the surrounding tissues and preserves collagen. And this is the main secret of plump lips after this procedure. It is very important to strictly adhere to the dosage of the injected drugs - a maximum of 1.5 ml for each lip. Exceeding this dose is fraught with local reactions in the form of hyperemia and itching of the skin in the mouth area, as well as a violation of the natural shape of the lips due to uneven distribution of the drug. But the most common reaction is swelling after hyaluronic acid injections into the lips. In the absence of aggravating circumstances, redness, swelling and traces of youth injections disappear after a few days.

And injections of hyaluronic acid under the eyes are considered an effective (albeit temporary) means of removing chronic "bruises" in the eye socket area. However, after such a procedure on such a delicate area of the skin of the face, unwanted side effects often occur (more on this below).

Injections of hyaluronic acid into joints

They are used in orthopedics and rheumatology to replenish the lack of synovial fluid in the joint capsule and increase its viscosity in order to improve the condition of synovial cartilage in arthritis and osteoarthrosis of the knee and hip joints, as well as in other joint pathologies of a degenerative-dystrophic nature.

Injections of hyaluronic acid into joints - 1% sodium hyaluronate solution - are usually done once a week, the procedure is repeated three times. In clinical practice, such drugs as Synvisc (USA), Sinocrom (Austria), Hi-Flex (Korea), Hyalgan (Hyalgan Fidia Farmaceutici, Italy) and others are used to treat joints.

As orthopedic doctors note, injections make the intra-articular lubricant in the synovial cavity of the joints more viscous. This restores its shock-absorbing properties, significantly improves the sliding of articular cartilage, protects them from damage, and also helps relieve inflammation and pain.

Harm

Some deny the harm from hyaluronic acid injections, and completely in vain.

Firstly, if a person has a congenital tendency to autoimmune skin reactions (which he may not even be aware of), then as a result of beauty injections they can trigger the development of lichen planus, systemic lupus erythematosus or psoriasis.

Secondly, being an important component of the extracellular matrix, hyaluronic acid takes an active part in the division (proliferation) of cells, including neoplasm cells. Studies have shown that the level of hyaluronic acid in tumor tissues is significantly higher than in normal ones. So, an injection of youth can cause the appearance of benign neoplasms in the form of fibrous nodes or thickening of the subcutaneous fat tissue.

Finally, beauty injections, temporarily increasing its content in the extracellular matrix, can lead to an increase in the synthesis of hyaluronidase - an enzyme that accelerates the decomposition of hyaluronic acid by hydrolysis. This enzyme decomposes all glycosaminoglycans and thereby cleanses the extracellular matrix, including those tissues that are around the malignant tumor. Why is this dangerous? Because the hydrolysis of hyaluronic acid on the basal membranes of vascular tissue cells (under the action of hyaluronidase) promotes intravasation - the penetration of cancer cells into blood and lymphatic vessels.

Contraindications

Despite the specifics of the use of these drugs, there are serious contraindications to hyaluronic acid injections. These include:

• hypersensitivity to the components of preparations containing sodium hyaluronate;
• abrasions, cuts, hematomas and any other injuries, as well as foci of inflammation on the skin or in the subcutaneous tissue of the intended injection area;
• fungal diseases of the facial skin;
• previous surgical interventions on the skin or cosmetic procedures to exfoliate the stratum corneum (peeling);
• elevated body temperature;
• any infectious diseases, including acute respiratory viral infections and influenza;
• autoimmune dermatological diseases (psoriasis, atopic dermatitis, etc.); psoriasis);
• keloid disease (genetically determined tendency to form keloid scars on the skin);
• poor blood clotting (including after use of thrombolytics, anticoagulants or platelet inhibitors within the previous three weeks);
• pregnancy and lactation period;
• age under 18;
• deep wrinkles in old age.

There are a number of contraindications for hyaluronic acid injections into joints:

• inflammatory joint diseases (rheumatoid arthritis, arthrosis, idiopathic spondyloarthritis, etc.);
• skin infection, damage or inflammation of the skin at the injection site;
• liver failure (severe);
• exacerbation of any chronic diseases;
• venous or lymphatic congestion on the side of the affected joint;
• taking immunosuppressive drugs (to suppress unwanted immune reactions of the body);
• poor blood clotting;
• pregnancy and lactation period.

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Consequences

Without strict adherence to the rules of asepsis and antisepsis, youth injections, like any other procedure with damage to the skin, can be accompanied by the introduction of pathogens into the tissue. This is fraught with skin abscesses and necrosis. Also, painful sensations almost always occur at the injection site.

The consequences of hyaluronic acid injections may take the form of side effects, namely:

• allergic reaction;
• swelling of soft tissues of varying intensity in the area of the procedure performed;
• redness of the skin (hyperemia), often with itching of the skin;
• the appearance of papules (nodular rash);
• bleeding at the injection site and disruption of local blood circulation (if the needle enters a blood vessel);
• the appearance of a hematoma (bruise);
• the formation of a keloid scar at the injection site;
• wrinkling of the skin;
• hyperpigmentation of the skin in the injection area;
• activation of herpes in patients with a history of herpes eruptions.

The consequences associated with an excessive amount of the drug administered are that it moves away from the injection site.

Clinical observations indicate that youth injections can cause significant harm to health.

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What should not be done after injections?

During the first 24 hours after hyaluronic acid injections, you should not touch the injection sites, sleep face down, or overexert yourself physically.

In addition, for some time (two weeks or a little longer) it is absolutely forbidden to sunbathe or go to a solarium, swim (in a pool, river or sea), go to a sauna, or drink alcohol.

After the injection of youth, you cannot apply makeup with foundation, powder, etc. Without consulting a doctor, you should not use any cosmetic products for facial care.

In case of swelling, cold compresses and ice are very helpful. In case of inflammation, the doctor should prescribe the appropriate medications (most often, non-steroidal anti-inflammatory drugs).

Where can I do it and how much does it cost?

In cosmetology clinics, in plastic surgery clinics, in aesthetic cosmetology centers. Finally, in beauty salons. However, this procedure should only be performed by a certified doctor or cosmetologist with a medical education and the appropriate certificate.

The price of hyaluronic acid injections is directly dependent on the cost of the drugs used, which are produced abroad. The level of the institution providing this type of cosmetic services and the qualifications of the specialists play an important role in pricing. In addition, the number of injections during one procedure may vary, which also affects its cost (upward).

Average price for youth injections in Kyiv: lips, nasolabial folds – $200-600, forehead and area between eyebrows – $100-250, area around eyes – $200-300.

The average cost of hyaluronic mesotherapy in Kharkov fluctuates in the range from 2 thousand to 3.5 thousand UAH. But in each specific case, the patient must receive complete information about the drug that will be used for hyaluronic injection.

Reviews

It is not difficult to guess that reviews of hyaluronic acid injections posted on the Internet pages of cosmetology clinics and centers are only positive. But on other web resources you can also find unflattering reviews about this procedure.

Female users especially often refer to the experience of their acquaintances, relatives or girlfriends. Often this experience, quoting the classics, is "the son of difficult mistakes"... We especially liked one of the reviews about this procedure, the author of which advises women not to rely on someone else's experience in cosmetology, since the decisive role here is played by the individual characteristics of the body and its reaction to this or that procedure for the sake of beauty and eternal youth...

The American Society of Plastic Surgeons (ASPS) compares hyaluronic acid injections for the face with the action of an inflatable pillow to support facial structures and tissues. If you decide not to repeat hyaluronic acid injections for the face, the “pillow” will deflate, and your appearance will return to its original state: wrinkles will reappear, and plump lips will lose volume.