Objectives: The objective of this integrative review is to concisely establish the biostimulatory effects by measuring the neocollagenesis potential of the main dermal fillers currently on the market – hyaluronic acid (HA), calcium hydroxyapatite (CaHA), poly-L-lactic acid (PLLA) and polycaprolactone (PCL) –, used to approach facial/body rejuvenation, in order to assist not only in medical decision-making, but also to provide impactful data for optimizing results, in the field of Regenerative Aesthetic Medicine.
Introduction: The molecular bases of skin aging involve a complex biological process. The demand from patients, within the scope of Cosmiatry, to address aging complaints brings about the need for a better understanding of the dermal fillers currently in force, and their respective potential for neocollagenogenesis. Thus, we aim to elucidate the neocollagenesis potential of each of the non-permanent dermal fillers currently in force and then contribute concise data for association and optimization of results, with tissue regeneration and its regenerative aesthetic impact on patients.
Materials / method: This integrative review addressed a survey of review articles and clinical articles, involving the clinical experience of each of the main dermal fillers, using the PubMed-MEDLINE/PMC (National Library of Medicine) database, during April and May 2023 , using the following terms as keywords: “Hyaluronic Acid; Collagen; Hydroxyapatite; Regenerative Medicine; Fillers; Rejuvenation”, with a publication time restriction of the period from 2013 to 2023.
Results: Neocollagenesis allows new collagen through the activation of fibroblasts or epithelial cells, through inflammatory or regenerative pathways. In the literature, there are comparative studies of the potential for collagenogenesis in mouse models and in human tissue biopsies. HA has a minimal and contradictory level of neocollagenogenesis, compared to PCL, PLLA and CaHA. Biostimulators with regenerative potential are less inflammatory and tend to be more promising, when inserted in the context of Regenerative Aesthetics, due to their potential for rejuvenation and local functional optimization.
Conclusion: Although several fillers induce neocollagenesis, the product must be selected based on the anatomical site and patient-specific soft tissue dynamics. There are differences between collagen stimulators, but no standardized clinical studies have been performed to date to broadly compare them. Regenerative Aesthetics is fascinating, but it still requires many studies involving tissue engineering work, to elucidate the inflammatory and neocollagenogenesis pathways, as well as optimize them and provide data that will allow doctors to select interventions with appropriate products.
Disclosures
Did you receive any funding to support your research for this TOPIC?
No
Were you provided with any honoraria, payment or other compensation for your work on this study?
No
Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No
Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No
This work was not supported by any direct or non direct funding. It is under the author's own responsability
