A Comparative Case Study on Echographic Behaviour of Selected Soft Tissue Fillers

Soft tissue fillers, whether based on cross-linked hyaluronic acid (HA) or other ingredients like calcium hydroxyapatite (CaHA), have been developed for long-term facial volume restoration. This case study aims to assess the behaviour, efficacy, durability, tolerability, integration, and degradation of selected soft tissue fillers in treating soft tissue deficits. Nine subjects were randomly divided into three groups, each receiving different soft tissue dermal fillers. Symmetrically, 0.5 ml of product was administered per side subcutaneously in the zygomatic arch area using a sterile 22G cannula via puncture with a sterile 21G needle. Patients underwent treatment at baseline (week 0), with no optional touch-ups allowed. Assessments were conducted at month 1, 3, and 6 using the HF-USG imaging. High-frequency ultrasonography (HF-USG) imaging of the zygomatic arch area was performed at all visits. Adverse events (AEs) were monitored and recorded. Analysis of HF-USG images indicated superior properties for PEGDE cross-linked acid, with no reported adverse events. All participants demonstrated aesthetic improvement, with projection and volumetric effects varying among the filler types. The study underlines the importance of filler selection and anatomical knowledge in achieving desired outcomes. High-frequency ultrasound offers valuable insights into filler behaviour and tissue response. Further research with larger sample sizes is warranted to validate these findings and explore additional parameters.