DERMAL FILLERS - Hyaluronic acid

50 % of hyaluronic acid in our body is found in the skin. Hyaluronic acid can absorb liquid in a volume 1000 times larger than its own, thus acting as an excellent "sponge" under the skin. There are about 15 grams of hyaluronic acid in a 70 kilogram body.


  • filling wrinkles and facial expression lines
  • volume increase (lips, cheekbones)

Functions of hyaluronic acid in the skin:

  • it is a structural component of the extracellular matrix
  • stimulation of the production of collagen, elastin and endogenous hyaluronan
  • regulating the diffusion of water, electrolytes, and nutrients
  • skin filler
  • high water binding capacity

METABOLISM - reduction of hyaluronic acid in the skin:

  • oxidation by hydroxylation of glucuronic acid
  • enzymatically via hyaluronidase

Hyaluronic acid is a polysaccharide (made up of sugar molecules): D-glucuronic acid and N-acetyl-D-Glucosamine.

Chemical structure of hyaluronic acid (GAG)

GAG or glycosaminoglycan is a general name for a number of similar molecules found in the plant and animal world and which have the function of creating tissue structure. Examples of GAG molecules are cellulose in the plant world and chitin in the animal world. Hyaluronic acid is polysaccharide with a repeating unit disaccharides which contains D-glucuronic acid and N-acetyl glucosamine with ß-(1-3) protein-binding compounds. Each polysaccharide unit is cross-linked with ß-(1-4) compounds. Hyaluronic acid has a molecular weight between 5,000 and 20,000,000 Daltons. Hyaluronic acid derived from synovial fluid has a molecular weight of approx. 3,500,000 Daltons.

Molecular weight – Determines the viscosity and strength of the product at a certain concentration of hyaluronic acid. The higher molecular weight means that the product can have a lower concentration of hyaluronic acid and still maintain the same level of viscosity.

Viscosity – Describes the "density" of the product. A higher viscosity means that the product is thicker and has more stability inside the skin.

Modulus of elasticity (G') – Describes the tendency of a substance to elastically (non-permanently) deform when a force is applied to it. A higher modulus of elasticity means that the product is more suitable for deep lines.

Shear Stress – Describes how easily a product changes from a solid to a liquid state. The high shear stress factor will allow the product to easily change when absorbed into the skin and to regain its shape once inside the skin.

Biological vs bacterial HA

Biological hyaluronic acid
  • biological source
  • high molecular weight, 4-6 MDa
  • medium (smooth) to high (ease) viscosity
  • medium (smooth) to high (ease) G'
  • high shear stress factor
Bacterial hyaluronic acid
  • bacterial source (usually Streptococcus Equi)
  • low molecular weight, 1-2.5 MDa
  • low to high viscosity
  • low to high G'
  • low to medium shear stress factor
Chemical structure of hyaluronic acid


  • "NON-PERMANENT" dermal implant
  • there is no risk of allergic reactions
  • longer duration in the tissue (high content of hyaluronic acid + cross-linking agent of the new generation (DVS-Divinyl sulfone)
  • ophthalmological quality according to appropriate standards
  • homogeneous distribution in the tissue
  • superior tissue filling and lifting capacity
  • high performance and security
  • made in and certified in the EU (Italy)


Cross-linked hyaluronic acid

Purpose of networking:

  • stabilization in tissue
  • slowing down bio-degradation (decomposition)
  • longer duration in the tissue

2 most commonly used networking tools:

  • DVS (molecular weight = 118) – first photo
  • BDDE (molecular mass = 202 - second photo

The most common places of application:

  • facial wrinkles: often found in young patients (25 and older)
  • glabella
  • forehead
  • Crow's feet
  • perioral lines
  • nasolabial folds
  • lowered corners of the lips
  • scars and wrinkles in general

Application in dentistry

Hyaluronic acid is physiologically the most important proteoglycan found in the mucous extracellular matrix, where, together with other components of the connective tissue, it ensures its strength and elasticity, which are very important for the health of the oral cavity.

In dentistry, it is most often used to prevent i treatment of periodontal diseases, but it certainly has multiple applications: it improves wound healing and tissue regeneration affected by gingivitis or periodontitis, promotes healing of the oral mucosa in case of stomatitis (aftha), reduces irritation of the oral mucosa caused by fixed and mobile prosthetic restorations, promotes wound healing after surgical procedures, cares for and maintains the health of the gingiva after the installation of dental implants, promotes wound healing in case of loss of primary teeth and prevents bleeding gums.

Also, hyaluronic acid, due to its biodegradation and biocompatibility, has proven to be excellent grid for regeneration of the dental pulp. Topical application of hyaluronic acid immediately reduces the discomfort that occurs in aphthous stomatitis. Hyaluronic acid has a multiple positive role in dentistry, and there are a number of gels on the market that contain it and can be "coated" with the gums after regular dental hygiene.

Why choose dermal fillers?

 - visible effects after the first application
– lasts up to 8 months
– application is simple and effective
– the product is the result of EU research

– very tolerable, almost endotoxin-free


  • pregnancy
  • psychosis
  • dysmorphophobia
  • autoimmune diseases
  • ASK 100: not a contraindication, however, hematoma formation is possible

Possibility of accelerated decomposition

  • younger people (active hyaluronidase, accelerated metabolism, intense physical activity, being outdoors and exposure to UV rays...)
  • UV damaged skin
  • frequent UV exposure
  • facial wrinkles and strong facial expressions
  • men