ORIGINAL RESEARCH Evaluation of the Performance and Tolerance of the Combination of an HA-based Filler with Tri-Hyal Technology and a Skin Biorevitalizer on Skin Aging Parameters Ferial Fanian 1 , Valerie Philippon 2 , Mihai Gorj 3 , Elena Rumyantseva Mathey 3 , Maxence Caillens 4 , Ranesha Goorochurn 5 , Shannel Curic 1 , Philippe Humbert 6 1 FILLMED Laboratories, Paris, France; 2 Private Clinic, Boulogne Billancourt, France; 3 Private Clinic, Paris, France; 4 Private Clinic, Sarcelles, France; 5 Dermo Dev Partners, Paris, France; 6 Private Clinic, Ornans, France Correspondence: Ferial Fanian, Scientifc Department, FILLMED Laboratories, 2 rue de Lisbonne, Paris, 75008, France, Tel +33 6 73 76 18 20, Email fanian@gmail.com Background: Biorevitalization solutions contain numerous nutritive compounds to improve skin quality. Dermal fllers like HA (hyaluronic acid), depending on rheological characteristics, are used to fll large static defaults with a sustained long-term effcacy. Treatments with either dermal fller or biorevitalization solutions alone are not enough to bring a global facial aging approach. Objective: To demonstrate the anti-aging performance and safety of a new protocol, BIONUTRILIFT, which combined an HA-based fller with Tri-Hyal technology and a skin biorevitalizer, to target the skin quality and wrinkles correction at the same time. Materials and Methods: Eligible subjects were enrolled based on a score of 2, 3, 4, or 5 on Bazin cheek folds wrinkle scale. Safety outcomes measured were immediate and local tolerability. Performance outcomes measured included: proportion of subjects in whom the severity of cheeks folds, nasolabial folds, marionette lines, upper lip wrinkles and skin radiance remained at least one point below the baseline measurement (Bazin scale) Global Aesthetic Improvement Scale scores by subjects and investigators. Results: In performance analyses with the combined protocol, skin radiance and cheek folds wrinkle correction sustained during the four-month study and decrease by 61% and 55%, respectively. 96% and 77% of subjects respectively showed at least a one-point decrease in the mean skin radiance score and Bazin score compared with baseline. Interestingly, the BIONUTRILIFT protocol showed the distance effect of vector A (cheek injection) and vector B (mandibular injection) on perioral zone and remained signifcant even 120 days after injections. Adverse events (AEs) were consistent with the expected AEsthat occurred after dermal injections. No serious AEswere recorded. Conclusion: BIONUTRILIFT may satisfy the subjects’ demand by obtaining in the same session a simple, personalized, noninvasive, atraumatic, and reproductible technique. Keywords: dermal fller, biorevitalization, combined protocol, distance effect Introduction Aging is a complex phenomenon including, over time, many structural changes. Face aging is characterized by a loss of skin volume, a decrease and a redistribution of fat, mainly in the orbital and malar areas. In parallel, there is a decrease in collagen production, reduced fbroblastic activity, dermal atrophy, and alteration of elastin. At the level of the skin a reduction in cell renewal, dehydration, loss of radiance, elasticity, frmness, and the appearance of fne lines and wrinkles are observed. In order to slow down facial aging, nonsurgical solutions enable patients to have simple and effcient treatments, such as injectable anti-aging products: biorevitalization products, dermal fllers and hyaluronic acid (HA)-based formulation for skin rejuvenation. The most commonly biorevitalization solutions are vitamin blends, trace elements, organic silicon, Clinical, Cosmetic and Investigational Dermatology 2023:16 1095–1105 1095 © 2023 Fanian et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). Clinical, Cosmetic and Investigational Dermatology Dovepress open access to scientific and medical research Open Access Full Text Article Received: 14 July 2022 Accepted: 19 January 2023 Published: 24 April 2023 Clinical, Cosmetic and Investigational Dermatology downloaded from https://www.dovepress.com/ on 26-Apr-2023 For personal use only.