The Hyaluronic Acid Fillers Current Understanding of the Tissue Device Interface

This article is a detailed summary of the device tissue interface regarding cosmetic injectable fillers, specifically focusing on hyaluronic acid fillers. Hyaluronic acid-injectable fillers are used extensively for soft tissue volumizing and contouring. Many different hyaluronic acid-injectable fillers are available on the market and differ in terms of hyaluronic acid concentration, particle size, cross-linking density, requisite needle size, duration, stiffness, hydration, presence of lidocaine, type of crosslinking technology, and cost. Although much is known about how the devices interact with biologic tissues and how they produce their effects, they continue to be actively studied for tissue engineering purposes. The biomechanical and biochemical effects of HA on the local microenvironment of the injected site are key to its success as a soft tissue filler. Knowledge of the tissue device interface will help guide the facial practitioner and lead to optimal outcomes for patients.