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Reasons why you should not easily receive hyaluronic acid injection and things you should know be...




Hidemasa Shinohara
Dr. Hidemasa Shinohara

Skin Refine Clinic Ginza

Regular member of the Japanese Society of Plastic Surgery Certified specialist Regular member of the Japanese Society of Clinical Dermatology Regular member of the Japanese Society of Cranial Forehead Surgery

Medical institution with Dr. Hidekatsu Shinohara

skin refine clinic skin refine clinic ginza
Contact: 0120-661-062

p> Hyaluronic acid injection is one of the most popular treatments, as it is recognized for its immediate effect.

In addition to the fact that changes appear immediately after injection with a single injection, there is little physical damage unlike surgical procedures such as incisions, and if the finish is not satisfactory, hyaluronic acid can be dissolved with hyaluronidase. This is probably the reason why it is such a popular procedure.

However, hyaluronic acid injection does not give the same result at all medical institutions and by injections by all practitioners . There are also cases where tear bag formation and lip hyaluronic acid injection are popular, or because a friend was doing it and it looked good, so they took it easily and failed.

In addition, there are many types of hyaluronic acid preparations, and it is important not only to have performance but also to select a highly safe preparation for each case.

In order to obtain a highly satisfying injection effect with hyaluronic acid injection, it is important to know the risks of hyaluronic acid injection and how to reduce the incidence of risk.

Reasons why you should not easily receive hyaluronic acid injection and things you should know before receiving

Hyaluronic acid injection where the incidence of complications varies depending on the practitioner

Hyaluronic acid injection treatment is becoming increasingly popular, but it is not recommended to take it easily because the results are greatly influenced by the doctor's knowledge and injection technique .

Risk of Complications in Hyaluronic Acid Injection

Injection of hyaluronic acid can cause complications such as internal bleeding/erythema, edema/swelling, delayed allergic reaction, foreign body granuloma, and Tyndall phenomenon, as well as serious complications such as skin necrosis, cerebral infarction, and blindness .

Of these, internal bleeding/erythema and edema/swelling are complications that can occur regardless of who the practitioner is and the type of hyaluronic acid preparation. The probability of occurrence changes depending on the nature of itself.

Foreign body granuloma A lump caused by chronic inflammation caused by a foreign body
Tyndall phenomenon It tends to occur around the orbit where the skin is thin, and the subcutaneous hyaluronic acid particles appear pale.
unnatural unevenness It tends to occur around the orbit, where the skin is thin, and when you make a facial expression, the hyaluronic acid swells due to the movement of the orbicularis oculi muscle around the eyes.
skin necrosis The main cause is direct blockage of blood flow due to erroneous intravascular injection or indirect blockage of blood flow due to compression of blood vessels due to perivascular injection.
cerebral infarction Cases reported after glabellar injection
blindness It is thought that erroneous injection into arteries causes hyaluronic acid to spread and block blood vessels, resulting in insufficient blood flow to the retina, leading to blindness.

There is little risk if the practitioner has a lot of practical experience

The structure of the face is layered with the skull, muscles, subcutaneous tissue (fat), and skin, and depending on the part, it is more complicated.

Without an understanding of the anatomical structure of the facial blood vessels and injection techniques, the incidence of complications increases due to erroneous injection into the blood vessels and pressure on the blood vessels due to excessive injection.

However, doctors who have anatomical knowledge, injection techniques, and aesthetic sense and have a lot of experience in actual battles rarely have injection errors or over injections .

Therefore, for example , it is wise to avoid receiving hyaluronic acid injection easily based only on price, and to choose a doctor who has a lot of practical experience and receive the treatment .

Incidence of complications that changes depending on the hyaluronic acid preparation

In recent years, complications such as swelling at the site of injection of hyaluronic acid due to coronavirus infection and vaccination have been reported.

Allergies and rejection reactions have been confirmed as complications of hyaluronic acid injections for some time, but they are thought to be triggered by the activation of the whole body's immunity by coronavirus infection and vaccination.

Allergy/rejection reaction where the injection site swells after a while

Even if there are no abnormalities immediately after injection, symptoms such as swelling or redness at the injection site may suddenly appear several weeks to several months later. Although rare, it is a nasty complication when it occurs.

The cause of allergic/rejection reactions is not clearly known, but cross-linking agents, bacteria, and antibodies against hyaluronic acid are thought to be involved. It is thought that the cross-linking agent leaks out during the process of hyaluronic acid degradation, and inflammation involving macrophages and plasma cells occurs against metabolites such as mucopolysaccharides.

Molecular weights of cross-linking agents and hyaluronic acid reported to affect allergic and rejection reactions

Most hyaluronic acid preparations contain a cross-linking agent that binds the hyaluronic acid chains together.

By including a cross-linking agent, the injection effect can be expected to last longer, and the forming and lifting power tend to improve.

However, if the cross-linking agent ratio is high, it is said that when injected into the skin, the flexibility to adapt to the movement of surrounding tissues and external pressure will decrease . It is said that this causes lumps and unevenness, and increases the risk of redness and inflammation .

In addition, macrophages are white blood cells that cleanse the body by preying on cells and substances that are no longer needed by the body and bacteria that have invaded the body. found that low-molecular-weight hyaluronic acid has the ability to induce inflammation . On the other hand, high-molecular-weight hyaluronic acid was found to have an anti-inflammatory effect.

Kaisense, a hyaluronic acid preparation that is less likely to cause allergic or rejection reactions

Various pharmaceutical manufacturers provide hyaluronic acid formulations with various properties, but the types of hyaluronic acid formulations handled differ depending on the medical institution.

At each medical institution, the introduction of hyaluronic acid preparations is decided based on a comprehensive judgment based on the purpose of treatment, usability, preference of the practitioner, reliability and safety.

One of the hyaluronic acid preparations that combine safety and performance is KYSENSE, which was launched in the EU in February 2021.

Kaisense is attracting attention for its high safety for the following two reasons.

  • Very low cross-linking agent ratio
  • High-molecular-weight hyaluronic acid is the main component

Allergies and rejection reactions have been reported to be affected by cross-linking agents and low-molecular-weight hyaluronic acid. Therefore, by choosing Kaisense that meets the above two conditions, it is highly likely that the risk of complications such as allergies and rejection reactions can be avoided .

Risk of cross-linking agents contained in hyaluronic acid preparations

A cross-linking agent is included in all hyaluronic acid preparations and has the role of an adhesive that connects hyaluronic acid molecules together.

A large amount of cross-linking agent increases viscoelasticity and cohesiveness, which has the advantage of making it easier to maintain the effect of supplementing volume, but on the other hand, it is also known to increase the risk of complications such as redness and inflammation due to allergic reactions. .

Choosing a hyaluronic acid preparation with the lowest possible cross-linking agent ratio will help avoid the risk of complications .

Kaisense is a hyaluronic acid formulation designed with an extremely low percentage of cross-linking agents.

Why hyaluronic acid preparations need a cross-linking agent

The molecular structure of hyaluronic acid is like a chain in which a number of molecules of glucuronic acid, a type of acid, and N-acetylglucosamine, a type of sugar, are alternately bonded.

Hyaluronic acid present in the human body is called high-molecular-weight hyaluronic acid because it has a chain molecular structure in which the chains are naturally long.

On the other hand, the artificially produced hyaluronic acid used in cosmetic medicine is short hyaluronic acid and low-molecular-weight hyaluronic acid that are not connected to each other.

Low-molecular-weight hyaluronic acid is easily decomposed and absorbed by enzymes present in the body, resulting in a shorter duration of effect.

Therefore, hyaluronic acid formulations used in cosmetic medicine must contain a cross-linking agent that connects the chains of hyaluronic acid in order to make it easier to shape and prolong the duration.

High molecular weight hyaluronic acid is less likely to induce inflammation

The molecular weight of hyaluronic acid varies depending on the hyaluronic acid formulation, but Kaisense is mainly composed of high-molecular-weight hyaluronic acid.

As mentioned above, there is a report investigating the difference in macrophage activity depending on the molecular weight of hyaluronic acid, and it is known that high-molecular-weight hyaluronic acid has an anti-inflammatory effect that suppresses inflammation .

Kaisense is a hyaluronic acid formulation with high performance

Kaisense is characterized not only by its safety, but also by its high performance. The following three points are considered to be high performance.

  • It has a high uplifting power that lifts the skin tissue, and a small amount can be lifted (increased volume).
  • Adapts to the skin tissue and is difficult to touch, and is soft but does not lose its shape
  • Natural finish and long lasting

Lift up even a small amount because of its high uplifting power

Kaisense's patented OXIFREE manufacturing method enables the retention of long chains of high-molecular-weight hyaluronic acid by thoroughly eliminating active oxygen generated during the manufacturing process. Therefore, even with a small amount of cross-linking agent, it maintains high viscoelasticity and has a high ability to lift skin tissue, so it is said to achieve high forming and lifting power .

It is soft but does not lose its shape and lasts for a long time.

Until now, hyaluronic acid formulations have been considered to be less likely to lose their shape and last longer as they are harder. There were disadvantages such as knowing that the injection was made.

Kaisense has a natural finish and is characterized by being difficult to touch when touched. Although it is soft, it does not easily lose its shape and is said to last for a long time .

To obtain a highly satisfying injection effect with hyaluronic acid injection

In order to obtain a highly satisfying injection effect with hyaluronic acid injection, in addition to choosing an experienced doctor and a hyaluronic acid preparation with low risk, it is also important to have a doctor with design sense and aesthetic sense .

In hyaluronic acid injection, accurate anatomical knowledge to prevent accidents, updating of new injection concepts and injection techniques, and planning to bring out natural beauty with a minimum amount of injection to avoid "hyaluronic acid overdose syndrome". It is important and requires design and aesthetic sense.

For example, if a patient is suffering from nasolabial folds, it is necessary to create a design with an image of how the overall balance will be unnatural if only the nasolabial folds are treated locally.

Even a small amount of Kaisense has a strong ability to lift the skin tissue, so a technique is required to inject it evenly and without unevenness. Due to the characteristics of the product, it can be said that it is a little difficult to handle for doctors with little experience and technology in injection treatment.

Even if the safety and performance of hyaluronic acid preparations are high, if the practitioner's technique is immature, the maximum performance cannot be achieved.

Having a doctor who has a design sense and aesthetic sense to inject after looking at the overall balance is also an important factor in increasing satisfaction with hyaluronic acid injection treatment.

Medical institution with Dr. Hidekatsu Shinohara

skin refine clinic skin refine clinic ginza
Contact: 0120-661-062