The Efficacy and Safety of Combining Cross-Linked Hyaluronic Acid Filler VYC-12L and Energy-Based Devices for Facial Skin Quality Improvement in Asians.

[BACKGROUND] In recent years, treatments using energy-based devices (EBDs) aimed at skin quality improvement have become widely adopted. However, it has been pointed out that treatments using EBDs alone show limited durability of effects and variability in patient-perceived improvements. Therefore, we evaluated skin quality improvement resulting from a combination therapy involving cross-linked hyaluronic acid (CL-HA) filler and EBD treatments tailored to patients' chief concerns.

[OBJECTIVE] To assess the efficacy and safety of combined CL-HA filler and EBD therapies in treating facial skin quality improvement among Asian subjects.

[METHODS] In this prospective, evaluator-blinded study, 18 participants aged 32-59 years with decreased skin elasticity, fine wrinkles, uneven texture, pore enlargement, pigmentation, and sagging were enrolled. CL-HA filler (VYC-12L) was injected intradermally into the entire face. One month later, according to each patient's primary concerns and symptoms, EBD treatment (either high intensity, high frequency parallel ultrasound beam [PUB], picosecond alexandrite laser [PSAL], and sequential monopolar bipolar pulsed radiofrequency [SMBPRF]) was administered to the entire face. Evaluations were conducted at three time points: baseline (T0), 4 weeks post-CL-HA injection (T1), and 8 weeks post-EBD treatment (T2). Subjective assessment was performed using the FACE-Q | Aesthetics-Satisfaction with Skin scale. Objective assessment was independently conducted by a dermatologist utilizing three-dimensional image analysis and skin diagnostic imaging with the Global Aesthetic Improvement Scale (GAIS).

[RESULTS] All participants completed the study. Pairwise comparisons of the FACE-Q skin satisfaction scores demonstrated statistically significant improvements at all time points: from T0 to T1 (p < 0.05), from T0 to T2 (p < 0.001), and from T1 to T2 (p < 0.001). Objective assessment with the GAIS showed improvement in all cases: very much improved (2 cases), much improved (9 cases), improved (7 cases), no change (0 cases), and worsened (0 cases). Regarding safety, no severe adverse events were reported, and only minor transient post-treatment reactions were observed.

[CONCLUSIONS] The combination of CL-HA filler and EBD represents a safe and effective therapeutic approach for enhancing facial skin quality in Asian subjects.