Pneumatic Delivery of Hyaluronan for Skin Remodeling: A Comparative Review

February 2020 | Volume 19 | Issue 2 | Original Article | 170 | Copyright © February 2020

Published online February 24, 2020

Yuri Vinshtok MD,a Daniel Cassuto MD,b Inna Belenky PhDc

aPerfAction Technologies, Rehovot, Israel bPrivate practice, Milano, Italy cIndustry scientific expert, Israel

Abstract
Jet Volumetric Remodeling (JVR) utilizes the principle of superficial soft tissue delivery of fluids, such as hyaluronic acid (HA) and other therapeutic materials. Dermal delivery of HA activates fibroblasts increasing collagen and elastin synthesis with a long-lasting dermal remodeling and thickening effect. JVR-injected HA causes immediate and diffuse skin hydration resulting in an aesthetically pleasing aspect. JVR technology is able to target different layers during the same treatment with only minor side effects. The article reviews JVR delivery of hyaluronan in comparison to current skin remodeling treatment modalities.

J Drugs Dermatol. 2020;19(2)170-175 doi:10.36849/JDD.2020.3641

INTRODUCTION

MAging visibly affects the skin appearance and is due to two main factors: environmental (extrinsic) and genetic (intrinsic), resulting in decreased dermal thickness and diminished fibroblast activity of the aging skin. UV exposure specifically reduces collagen synthesis and causes its degeneration.1,59

Therefore, the main goal for correction of the skin thickening is to successfully stimulate collagen and elastin synthesis in the dermis. Various energy-base devices (EBD) (thermal, light, infrared, radio-frequency) can stimulate collagen synthesis and tightening leading to thicker and firmer skin, whilst restoring elastin with the EBD has not been definitely demonstrated yet. Micro-needling, dermal fillers, dermal threads and platelet rich plasma have been also reported as effective for wrinkles reduction and tightening effect.1-3

Jet Volumetric Remodeling (JVR) utilizes the principle of superficial soft tissue delivery of fluids, such as hyaluronic acid and other therapeutic materials. A pneumatically accelerated jet penetrates the epidermis through a small entry point and immediately disperses the fluid in a 3-D way.4,42 The accelerated dispersion of the fluid particles creates multiple nano-traumas to the surrounding tissues fibers (Figure 1). An activated repair results in dermal thickening and strengthening over time.5 JVR technology (EnerJet, PerfAction Technologies, Rehovot, Israel) accurately controls depth and volume of the delivery allowing for optimal penetration and distribution as needed through the treatment.






There are a growing number of publications describing clinical efficacy of JVR method in skin thickening and other aesthetic indications. The aim of this paper is to review JVR delivery of hyaluronan in comparison to current skin remodeling treatment modalities.

Biological Effect
Progressive degrading of collagen and elastin fibers results in gradual reduction in dermis thickness and reduced density of retinacula cutis.6,7 EBDs promote collagen remodeling through