Midface volumization and skin quality enhancement with a hyaluronic acid–polynucleotide hybrid filler: a 24-week prospective open-label study

BACKGROUND: Facial aging is characterized by midface volume loss from structural and dermal atrophy. OBJECTIVES: To evaluate the efficacy and safety of a hyaluronic acid-polynucleotide (HA-PN) hybrid filler for temporary restoration of anteromedial cheek volume. METHODS: In this single-center, open-label trial, 15 adults with moderate-to-severe anteromedial cheek volume loss (Mid-Face Volume Deficit Scale [MFVDS] score ≥ 3) received up to 1 mL HA-PN hybrid filler per side. Evaluations at baseline and weeks 4, 12, and 24 comprised blinded photographic MFVDS rating (primary endpoint: ≥1-grade improvement at week 4), GAIS (Global Aesthetic Improvement Scale) score, participant satisfaction, transepidermal water loss, skin hydration, elasticity, and adverse events. RESULTS: All participants completed the study without serious adverse events. MFVDS scores improved significantly at week 4 and remained improved through weeks 12 and 24. GAIS and satisfaction scores paralleled these gains. Transepidermal water loss decreased and hydration increased over time, and Cutometer parameters (R2 R5 R7) showed progressive improvements in elasticity, indicating enhanced skin quality along with midface volumization. CONCLUSIONS: The HA-PN hybrid filler demonstrated improvements in midface volume restoration with concurrent improvements in skin barrier function, hydration, and elasticity, and was well tolerated over 24 weeks within the constraints of the study design.