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Bon Betemps et al. Plast Aesthet Res 2018;5:19 I http://dx.doi.org/10.20517/2347-9264.2018.24 Page 5 of 8

Table 3. Projection heights of two HA volumizers obtained with the skin model assay
Product reference Projection heights (mm)
Gel D 2.38 ± 0.07
Juvéderm Voluma 1.77 ± 0.08

Figure 1. Illustration of projection heights measured with the skin model assay. Step 1: deposit of the tested HA gels; step 2: HA gels are
overlaid by the upper skin layer; step 3: measurement of the projection heights induced by each HA gel

This finding is consistent and in correlation with the rheological properties of the two studied HA volumizing
products. As described in previous publications on the key rheological features of HA fillers, the normal force
of compression F plays a key role in the projection capacity of the HA fillers: a high F enables the HA product
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to project more skin tissues. In this regard, the normal force F of compression can also be called the projection
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force to highlight its importance in the ability of tissue projection and volume creation. In the case of the
OXIFREE product and Juvéderm Voluma, as illustrated in Figure 2, the projection force F and the projection
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height are considerably higher for the OXIFREE product in comparison to Juvéderm Voluma, which explains
the much higher projection capacity of the OXIFREE product observed with the skin model assay.

The measurement of the projection capacity with the skin model assay is hence a new relevant tool for the
medical community, in addition to and in correlation with the rheological property F , to assess and compare
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the projection capacities of HA fillers. For the physicians, it makes it possible to select the HA volumizers
with the highest projection capacities to treat facial indications which require important volume restoration
such as the cheeks, cheekbones, chin, temples and jawlines. This selection enables the optimization of the
aesthetic outcomes and a better patient satisfaction.

In addition to the ability to demonstrate the projection capacity of the HA fillers, this new skin model assay
is easy and quick to perform, which makes it possible to visually observe the projection capacity of the
products on an applied model.