Expert Recommendations on the Use of a New Hyaluronic Acid Injectable for the Aesthetic Treatment of the Chin and Lower Face
January 2025 | Volume 24 | Issue 1 | 70 | Copyright © January 2025
Published online December 30, 2024
Andreas Nikolis MD PhD FRCSCa, Katie Beleznay MD FRCPCb, Vince Bertucci MD FRCPCc, Lisa Kellett MD FRCPCd, Andrei Metelitsa MD FRCPCe, Kucy Pon MD FRCPCf, Jason K. Rivers MD FRCPCg, Jennifer Salsberg MD FRCPCh, Hani Sinno MD FRCSCi, Desislava Lazarova MDj, Torun Bromée PhDk
aVictoria Park Medispas, Montreal, Quebec, Canada and Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
bHumphrey & Beleznay Cosmetic Dermatology, Vancouver, British Columbia, Canada; Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
cBertucci MedSpa, Woodbridge, Ontario, Canada and Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
dDLK on Avenue, Toronto, Ontario, Canada; eBeacon Dermatology, Calgary, Alberta, Canada and Division of Dermatology, University of Calgary, Calgary, Alberta, Canada; fSunnybrook Health Sciences Centre and Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
gPacific Derm, Vancouver, British Columbia, Canada and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada; hAvenueMD, Toronto, Ontario, Canada
iDr Sinno, Montreal, Quebec, Canada
jGalderma, Zug, Switzerland
kGalderma, Uppsala, Sweden
Abstract
The Restylane® portfolio of hyaluronic acid (HA) fillers comprises a broad range of products, each with a unique combination of gel strength/firmness and flexibility. Restylane® Shaype™ (HASHA) is a new HA injectable produced with NASHA-HD™ technology and the most recent addition to the Restylane portfolio. NASHA-HD is an evolution of the NASHA™ platform that adds more HA and uses a more efficient cross-linking even though the degree of modification is kept low. HASHA has an HA-concentration of 25 mg/mL and a G prime (G') of 916 Pa (0.1 Hz). Experts recommend using HASHA for treatment in the chin area because its high G' allows a higher degree of correction/projection with lower injection volumes, especially in those patients with pronounced chin retrusion, together with a long duration of effect and good overall safety. Depending on the patient's needs and the aim of treatment, different approaches and injection techniques should be applied. This paper reflects the recommendations of an interdisciplinary expert panel for the use of HASHA for the correction of the chin area, including patient selection, product volume, product placement, injection technique, and post-treatment care. Recommendations were discussed and agreed as a consensus, according to cross-sectional expertise and clinical experience.
J Drugs Dermatol. 2025;24(1):70-78. doi:10.36849/JDD.8593
INTRODUCTION
The Restylane® portfolio of hyaluronic acid (HA) fillers is engineered by 2 different and complementary technologies; NASHA™ and OBT™/XpresHAn™. Together, these 2 technologies allow for a broad range of products, each with a unique combination of gel strength/firmness and flexibility. NASHA gels (Restylane® and Restylane® Lyft™; Galderma, Uppsala, Sweden) are generally firm with high G prime (G'), while OBT gels (Restylane® Defyne™, Refyne™, Kysse™, and Volyme™; Galderma, Uppsala, Sweden) are softer and flexible, as demonstrated by their high xStrain.1
Restylane® Shaype™ (HASHA; Galderma) is a new HA injectable produced with NASHA-HD™ technology, and the latest addition to the Restylane portfolio. NASHA-HD is an evolution of the NASHA platform that incorporates more HA and employs a more efficient cross-linking while maintaining the same low degree of modification. This results in the product being even firmer compared with all other NASHA gels. HASHA has an HA-concentration of 25 mg/mL and G' of 916 Pa (0.1 Hz) and was specifically developed for lower face shaping and to be injected deeply on bone.2 In 2023, the product was first approved in Canada for temporary augmentation in the chin region.
