Resumen

Objectives: This study aims to establish a clinically applicable strategy for selecting hyaluronic acid (HA) fillers based on rheological properties—specifically, gel firmness (G’), flexibility (xStrain), and cohesivity. The goal is to enhance safety, predictability, and aesthetic outcomes by tailoring filler selection and injection techniques according to facial anatomy and movement dynamics. Introduction: Facial aging is a multilayered process involving volume loss, ligament laxity, and changes in skin elasticity. HA fillers have become essential in aesthetic medicine, but product selection often lacks scientific grounding. Understanding rheological behavior provides an objective framework to select appropriate fillers for specific anatomical needs—balancing support, mobility, and natural integration. Materials / method: We analyzed the rheological characteristics (G’, xStrain, cohesivity) of commonly used HA fillers using data from published literature and in vitro measurements. A region-specific treatment algorithm was developed using a layer-by-layer anatomical model. Clinical case reviews and visual assessments were conducted to evaluate volume retention, mobility adaptation, and patient satisfaction post-treatment. Results: High G’ fillers demonstrated superior lifting capacity and volume retention in structurally deficient areas such as the midface and chin. High xStrain fillers provided natural animation and improved integration in dynamic zones like lips and nasolabial folds. The layer-specific approach minimized complications such as lumpiness, migration, and unnatural appearance, enhancing overall treatment satisfaction. Conclusion: Filler rheology plays a critical role in achieving safe and natural aesthetic results. Scientific understanding of viscoelastic properties and their clinical implications enables practitioners to deliver customized, anatomy-driven treatments. A rheology-based filler strategy supports both function and form—leading to reproducible outcomes and higher patient satisfaction in facial rejuvenation.