Hydro Injections in Korea : A Complete Guide

Hyaluronic acid fillers were first introduced in Korea 20 years ago, when Restylane was approved in 1999. Today, the number of filler brands approved by the KFDA is over 150, and 20~30 brands are actively distributed in the market.

Among the many types of fillers, the most widely used is the Hyaluronic acid filler for its proven safety. Hyaluronic acid can be found naturally in eyes, bones and cartilage, but over 50% of HA in the body is found in the skin. This is why it has minimal side effects when injected in the skin, and if there is, it can easily be reserved using hyaluronidase to dissolve the hyaluronic acid.

Treated with 1.0 mL Restylane Defyne in the nasolabial folds and 1.0 mL Restylane Defyne in the marionette lines. 2 weeks after treatment.

In the early stages of its administration, fillers were primarily used for wrinkles around the eyes, between the eyebrows, and for nasolabial folds and marionette lines. In Korea, it was most widely used to get rid of nasolabial folds and marionette lines.

Treated with 2 mL Restylane Silk in the lips and perioral (lip) lines around the mouth. 2 weeks after treatment.

The next trend was using fillers to give volume to specific parts of the face. Areas like the cheek, lips and forehead, when given volume with fillers can give more defined facial features and help you look younger.

Areas treated: face and forehead. Products used: Restylane Skinboosters Vital & Vital Light

Then came the technique of injecting hyaluronic acid across the whole face, hence the hydro injection. As one gets older, the natural volume of HA in the body decreases, especially as one gets into his or her 40s. This causes your skin’s moisture retaining level to drop, which is why your face gets drier with age. On the face specifically, the drop in HA levels is more serious in the cheek area (called the U-zone) than the area (called the T-zone) where there are more sebaceous glands, the glands that make your skin oily. Hydro injection involves injecting Hyaluronic acid in minute amounts across a wide area of your skin, mainly this U-zone, to moisturize your skin and reduce light wrinkles.

Restylane® Vital injector with a metered dose injector that deposits 10 μL per injection site[/caption]

Restylane developed the Restylane® Vital injector as the first injector of its kind. It can inject controlled minute amounts of filler and was widely used to treat ice pick acne scars, but today the below injectors are used more commonly in Korea.

(From left) Dermaqueen®, Dermashine®, Restylane® Vital injector

 

Hydro injection injectors use negative pressure to suck the skin up and inject needles into the skin, thereby minimizing liquid loss and maximizing accuracy of injection depth. Pain is reduced as the injector lifts the skin to straighten the skin surface before the needle injection and can inject proportionally across the skin. When the HA is injected, it attracts water molecules hence the hydro effect.

data on file, Allergan Inc. Juvederm technical file

When HA molecules are connected in a matrix, this is called cross-linking. Cross-linking enables HA fillers to maintain its shape. HA fillers that are more cross-linked are usually used for lifting in areas like the nose and forehead where maintaining its shape is very important. For hydro injections, less cross-linked HA fillers are more suitable as it can spread across the area it is injected into and better at attracting and holding moisture.

Less cross-linked HA filler brands include Restylane Vital, Yvoirre hydro, juvederm volite, High Inj.

Embossing is a common side effect of hydro injection, where the skin forms small bumps or protrusions. This occurs in thin or sensitive skin, or when the filler is injected too close to the skin surface. For such skin, lower pressure levels should be used to avoid embossing.

However, even when embossing occurs, it usually goes away after 2 to 3 days. Also, since hydro injection injectors consist of very thin needles and injected in very precise distributions, the chance for bruising is very low.