Dermal fillers feel burdensome, so what makes HILO WAVE® different?

The situation where a dermal filler appears noticeable usually occurs when the gel is clumped in one area or overfilled. The stronger the cross-linking, the more the formulation tends to maintain its shape within the tissue. If the amount or layer is incorrect, it can feel like a foreign body or appear swollen, and may look unnatural when making facial expressions.

HILO WAVE® uses a formulation with minimal cross-linking, which is distributed in small amounts across multiple points in the dermis. Rather than noticeably changing facial contours, it tends to produce subtle volume-filling effects along with improved skin hydration and texture. Clinical studies have reported that injectable hyaluronic acid can improve skin quality indicators such as moisture, firmness, texture, and radiance of facial skin.

In other words, if you expect dramatic changes, it may feel underwhelming, but for those seeking natural results, it can be an excellent choice.

The phenomenon of filler migration, where the filler moves from the initial injection site to another area, has been reported in academic literature. It is explained by various mechanisms including the injection layer and amount, movement of the treated area, and tissue pressure, and it may be discovered months to years later.

HILO WAVE® tends to spread widely within the dermis rather than forming a clump, and it is metabolized over time. This is described as different from the 'mass migration' seen with fillers. Additionally, HILO WAVE® has a much higher proportion of non-cross-linked hyaluronic acid, so it does not last long in the body like fillers and breaks down within several months. However, it cannot be definitively stated that there is no possibility of migration. In either case, precise control of injection depth and amount is important.

One of the major advantages of hyaluronic acid-based products is that they can be dissolved using a degrading enzyme called hyaluronidase. For dermal fillers, which have a longer duration, this method is considered when the shape is unsatisfactory or when lumps or nodules occur.

The approach for HILO WAVE® is slightly different. Because it does not create a shape and spreads widely, a 'shape' that needs to be reversed rarely forms, so it is far from the idea of targeting and dissolving a specific lump, as with dermal fillers. Instead, because it has less cross-linking, it breaks down relatively quickly in the body and tends to return gradually to the original state over time.

The lower burden of reversal is an advantage, but for the same reason, it also means a shorter duration of effect. It is accurate to understand these two aspects as two sides of the same coin.

The most obvious limitation is volume. It is difficult to address areas requiring significant filling, such as deep nasolabial folds or a sunken forehead, with HILO WAVE® alone. Additionally, the duration of effect may feel shorter compared to dermal fillers.

Also, it is not typically a one-time procedure. Studies on microinjections of hyaluronic acid have reported that improvements in skin firmness and density were more pronounced in groups that received multiple sessions compared to a single session. A plan involving several sessions at intervals followed by periodic maintenance is necessary. The exact number of sessions and intervals depend on your skin condition.

It may not be suitable for those who desire immediate and visible changes or for those who find it difficult to divide the treatment plan into multiple sessions.

As with any injection procedure, there is some risk. Swelling and bruising are common after the procedure and usually subside within a few days, but recovery speed varies by individual. Rarely, infection, persistent inflammation, or pigment changes may occur.

Delayed complications such as swelling, nodules, and hypersensitivity reactions have been reported several weeks to months after procedures involving hyaluronic acid-based products in general. While formulations with fewer cross-links have a relatively much lower risk, it cannot be said that they never occur. Additionally, rare but serious complications caused by the injection solution affecting blood vessels have been reported across hyaluronic acid injection procedures.

Rather than asking 'which is better,' it is more helpful to first distinguish whether your concern is about shape, facial contour, and volume, or about skin quality. If you look in the mirror and see a specific area that appears sunken and shadowed, it is a matter of filling. If your skin overall looks dull and rough in texture, it is closer to a skin quality issue.

In actual clinical practice, the two issues are often mixed, so it is not resolved by one side alone. Rather than choosing HILO WAVE® simply because dermal filler feels burdensome, it can be more helpful for satisfaction to first identify what is the priority for your face and then decide.