Abstract
BACKGROUND: Facial rejuvenation involves addressing the breakdown of collagen and elastin that occurs with aging. Hyaluronic acid (HA)-based dermal fillers have become a key non-invasive treatment, known for their volumizing effects and potential regenerative benefits. This study characterizes the physicochemical and rheological properties of Hylan Gel Dermal Filler DX, a novel filler combining HA and dextranomer microspheres, and evaluates its capacity to enhance extracellular matrix regeneration. METHODS: Rheological analysis was conducted to determine viscoelastic properties, including storage modulus (G'), loss modulus (G''), and tan delta across frequencies (0.1-10 Hz). In vitro experiments with normal human dermal fibroblasts (NHDFs) and monocytes (J774A.1) assessed the effects of Hylan Gel Dermal Filler DX (HA + DX), Genefill Soft Fill (HA), HarmonyCa® (HA+CaHa), Radiesse® (CaHa), and Sculptra® (PLLA). Hydration and wound healing assays were also performed. Biomarker analysis focused on collagen types I, III, IV, VI, elastin, and cytokines (TGF-β1, IL-1β, IL-6, IL-10, TNFα). RESULTS: Rheologically, HA + DX displayed a balanced elastic and viscous profile, supporting its structural integrity and adaptability in dynamic facial areas. HA + DX demonstrated high stimulation of collagen types I, III, IV, VI, and elastin production, with enhanced fibroblast migration and wound healing at 72 hours compared to other fillers. HA + DX also modulated cytokines, increasing TGF-β1 and IL-10 while reducing TNFα and IL-1β, suggesting anti-inflammatory and regenerative properties. CONCLUSIONS: HA + DX exhibited considerable benefits in collagen stimulation, wound healing, and cytokine modulation. Its favorable rheological characteristics and regenerative potential make it a promising option for facial rejuvenation and tissue regeneration. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.