| The Hyal System makes use of the fact that native hyaluronic acid has a high level of biointeractivity and can therefore increase fibroblast activity and the neosynthesis of endogenous hyaluronic acid, elastin and collagen. Unlike highly cross-linked, chemically changed hyaluronic acids which are used exclusively as dermal fillers, the Hyal System* injection technique attempts to create attractive tissue by building up the extracellular matrix of the skin areas in three dimensions using small droplets, a method similar to that used in a spacelift.

The desired effect is achieved in 6 weeks at the latest. It is intended more as prophylaxis against aging skin and can also be used in the area of the neck, chest and hands.

In 1934, Karl Meyer and John Palmer isolated hyaluronic acid (a glu-cosaminoglycan) from the vitreous body of a cow's eye. Hyaluronic acid, a linear polymer, is made up of the disaccharide units D-glucuronic acid and N-acetyl-glucosamine. It occurs naturally in human eyes, in joint surfaces, and in the skin. In the skin, it serves as a substrate of the cell structure and the extracellular matrix. In the dermis, it is associated with the elasticity and hydration of the skin. It also increases fibroblast activity and the neosynthesis of endogenous hyaluronic acid, elastin and collagen. Until very recently, hyaluronic acid was considered to be only a space-filling substance with a purely mechanical function. We now know that hyaluronic acid specifically modulates biological processes in humans and animals via endogenous membrane receptors. Depending on the area of application, we can therefore regard hyaluronic acid both as a medication with a long-term pharmacological effect and as a medical product when only the viscoelastic properties of this macromolecule are used. In aesthetic medicine, it is used to reduce skin wrinkles, to increase regional volume, and to treat scarring, as well as to improve skin tautness and strength.

* Merz Pharmaceuticals GmbH, Eckenheimer Landstra├če 100, 60318 Frankfurt/Main, Germany.

In general, it is possible to distinguish the two products.

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