A recent article of mine published in the Teoxane Times (page 1)

TEOSYAL® RHA 4: THE IMPORTANCE OF DYNAMICS Our patients tell us that they want natural-looking rejuvenation. They want volume replacement but, critically, they still want to look like themselves.

As practitioners, our aim is to restore contours, shape and balance, and achieve a youthful, aesthetically pleasing result. What is often neglected is the requirement to consider not only the resting face but the face in animation. While age-related changes occur in all layers of the face, a focus on volumetric restoration leads us to consider the fat compartments as a priority. Facial fat is composed of deep and superficial layers, neatly divided by the superficial musculoaponeurotic system (SMAS) or mimetic muscles. These layers are further divided into compartments which follow a predictable pattern of depletion. In the deep layer most volume loss occurs in the lateral and medial sub-orbicularis oculi fat (SOOF), the deep medial cheek and chin fat compartment. In the superficial layer, most volume loss occurs laterally in the temporal and preauricular regions and, to a lesser degree, in the middle and medial superficial cheek fat compartments. The superficial nasolabial compartment and the superior and inferior jowl compartments are relatively unaffected by volume loss and may develop some hypertrophy. They tend to move medially because of a lack of fibrous fixation and lateral support. Further to the redistribution of fat and general volume depletion, the individual fat compartments become more discernible as separate entities.

Hyaluronic acid (HA) dermal fillers are well established as the most popular products for treatment of volume depletion and static lines. They are increasingly used in multiple planes, targeting the volume deficient compartments for a more natural and balanced effect. In recent years we have considered rheology important when selecting an HA filler. A higher viscoelastic modulus (measured as G*) relates to a harder product which is resistant to deformation and effects a better volumisation. Cohesivity of a product relates to its ability to stick together despite application of an external force compression.

TEOXANE LABORATORIES’ TEOSYAL® RHA 4 IS THE MOST VOLUMISING PRODUCT IN THE NOVEL RESILIENT HYALURONIC ACID (RHA) RANGE. Utilising longer HA chains, their 3D structure affords a dynamic stability due to the presence of natural, labile and mobile low-energy bonds, supplemented by a low ‘BDDE’ crosslinker rate of 4% to create anchor points. Possessing a high level of strength to resist pressure forces, while maintaining an impressive ability to stretch and accompany the dynamism of surrounding tissues, RHA 4 elicits, as demonstrated by clinical trials, an impressive clinical improvement both immediately and in the long run, and very high patient satisfaction.

RHA4 strikes an excellent balance between tolerability, product integration, volumisation, dynamism and longevity.