Written by/Reporter Wang Xueying Graphic Editor/Ji Jingjing
New Media Editor/Lv Bingxin
Everyone has a heart for beauty.
In recent years, the medical cosmetology industry has developed rapidly, and light medical cosmetology projects led by microplastic surgery have attracted more and more young people's attention. Compared with traditional aesthetic medical methods that require "surgery", most non-surgical types of light aesthetic procedures are mainly injection-based, with a short recovery period and relatively low price.
Among them, hyaluronic acid injection, as the trump card project in today's medical beauty market, has always been sought after by young people because of its ability to "quickly and effectively hydrate and moisturize, lighten wrinkles and remove wrinkles, and local plastic surgery".
However, the rapidly expanding aesthetic medicine industry has created a mixed and chaotic market: "Thrilling! After injecting 6 injections of hyaluronic acid, she was left with a lifelong disability! "200,000 injections of more than 20 injections of hyaluronic acid disfigurement", "A woman in Henan was compensated for death caused by hyaluronic acid injection, 1.6 million yuan"... In the endless related news, there are always similar tragedies unfolding. People can't help but ask, is hyaluronic acid an "angel" or a "devil"? Is injecting hyaluronic acid to pursue beauty really a deal with the "devil"?
The past and present of hyaluronic acid
Does the injection of hyaluronic acid cause a series of allergies, disfigurement and even death tragedies, mean that hyaluronic acid itself is a dangerous substance? The answer is no.
What we often call hyaluronic acid is actually a dermal filler with hyaluronic acid (HA) as the main component. As an acidic mucopolysaccharide, hyaluronic acid is a natural substance that is widely found in the body's connective tissue, epithelial cells, and nerve cells, and is key to the body's regulation of cell growth and renewal, and is therefore not dangerous in itself.
In 1934, Carl Meyer, a professor of ophthalmology at Columbia University, first isolated hyaluronic acid from the vitreous body of a bull's eye. Later, people began to extract hyaluronic acid from the connective tissue, umbilical cord, eyeball, and serum of animals. Due to the shortcomings of the extraction process based on biological raw materials such as difficulty in purification, high cost, and risk of animal origin, people have successively invented the microbial fermentation process represented by streptococcus and lactococcus fermentation method, and the chemical synthesis process using natural enzyme polymerization reaction, which makes hyaluronic acid purification more efficient, cheaper, safer and more suitable for large-scale production, and also makes hyaluronic acid "enter the homes of ordinary people" in the future.
Initially, hyaluronic acid was found to be an ideal medical material with very good absorbability and strong biocompatibility, and because it has the function of helping cell repair and regeneration, it is often used as joint lubrication, ophthalmic viscoelastic agent, clinical treatment of arthritis and ophthalmic surgery.
With the deepening of the research, researchers have found that the magic hyaluronic acid also has the effect of "skin care" - hyaluronic acid, which is widely present in the dermis layer and subcutaneous tissue of the human body, can not only help the skin better absorb moisture, but also enhance the skin's ability to lock water and moisturize. In other words, if you want to have "blow-crackable skin", the hyaluronic acid content in the skin is very important. Therefore, with the blessing of the upgrading of extraction technology, hyaluronic acid, which has greatly reduced its cost, has also begun to be widely used in the field of medical beauty.
According to Associate Professor Li Xiaofang of the Department of Plastic and Aesthetic Surgery of Xiangya Second Hospital of Central South University, the external use of hyaluronic acid is mainly applied to the surface of the skin, but the amount that can be absorbed through the skin is very small. The hyaluronic acid for injection in the medical beauty project is injected into the dermis layer and subcutaneous tissue of the human body through a needle, and is mainly used to fill scars and depressions on the human face, moisturize and hydrate, remove wrinkles and wrinkles, and shape the body.
Cross-linking agent that is constantly cut and messed up
Since hyaluronic acid itself is safe, why do people have rejection reactions after injecting hyaluronic acid? It turns out that one of the keys to the problem is to make hyaluronic acid truly become the "right-hand man" of hyaluronic acid - cross-linking agent.
Since the molecular structure is linear, hyaluronic acid in its original form exists in a liquid state. Although it can hydrate and moisturize the skin after injection, because it is liquid and quickly absorbed by the body, its shaping effect is minimal, and the maintenance time is very short, which is not an ideal filling material. However, when hyaluronic acid encounters a cross-linking agent, the molecular structure will change, and the texture will change from liquid to gel-like, which not only improves the hardness and elasticity of hyaluronic acid, but also prolongs the time for hyaluronic acid to be absorbed by the body, so that the effect can be maintained longer.
▲Schematic diagram of the concept of hyaluronic acid before and after crosslinking
In other words, it is the existence of cross-linking agents that makes hyaluronic acid have the function of shaping and filling. The more cross-linking agents added by hyaluronic acid, the higher the degree of cross-linking, the stronger the shaping ability, the more obvious the effect, and the longer the maintenance time.
However, it is such a "hero" that has become the culprit of the frequent "crisis" of hyaluronic acid: unlike hyaluronic acid, which exists in the human body, the cross-linking agent is an "outsider" for the human body, and the higher the degree of cross-linking, the greater the chance of hyaluronic acid causing immune rejection in the human body. For this reason, how to properly use the "double-edged sword" of cross-linking agents to balance the subtle relationship between effects and side effects has become the key to determining the quality of a hyaluronic acid.
Prices vary widely, what is the difference between different brands?
At present, the market is full of no less than ten different brands of hyaluronic acid, and their prices vary widely. The same is hyaluronic acid, why is the price difference so big?
In essence, all hyaluronic acid is a combination of "hyaluronic acid + cross-linking agent", but its final state is different due to the different production processes employed.
Under normal circumstances, the level of crosslinking technology can be measured from two dimensions: a good crosslinking process needs to ensure that the crosslinking agent can achieve the ideal crosslinking state, while reducing the sensitization rate to the human body as much as possible, the higher the crosslinking utilization rate, the lower the sensitization rate; Secondly, when the human body has a rejection reaction, a good crosslinking technology must ensure that hyaluronic acid can be quickly and comprehensively dissolved by lytic enzymes, so that the human body can quickly "process" the "outsiders" who trigger rejection reactions through metabolism.
Therefore, excellent crosslinking technology and production process not only determine the efficacy of a hyaluronic acid, but also determine its safety.
▲Conceptual diagram of single-phase (left) hyaluronic acid and biphasic (right) hyaluronic acid process
According to the degree of cross-linking, the texture of hyaluronic acid can be basically divided into two categories: single-phase and biphasic, and the scope of application of the two is also obviously different.
▲Schematic diagram of hyaluronic acid deformation and pressure bearing time of different textures, including biphasic hyaluronic acid (left + middle), single-phase hyaluronic acid (right) Source: Zhihu user @ Tenten
If single-phase hyaluronic acid with a higher degree of cross-linking is compared to glue and gel, then biphasic hyaluronic acid with a lower degree of crosslinking is more like sago dew. The former has higher viscosity, stronger shaping ability, will not be easily displaced, and lasts longer; The latter has better elasticity and ductility, and its shaping power is proportional to the size of the "sago dew grain" - the larger the particle and the longer it lasts, the more suitable it is for filling deep tissues such as facial apple muscle; The smaller the particles, the better the ductility and the more suitable for filling delicate areas such as tear troughs and lips.
▲The higher the degree of cross-linking of hyaluronic acid, the longer the maintenance time Source: Zhihu user @Drunken Pif
Regardless of market, marketing and other factors, from the perspective of production alone, the different crosslinking technology and process used directly cause the difference in the price of different brands of hyaluronic acid.
Since "you get what you pay for" makes sense, then consumers must be right to choose expensive?
In fact, beauty itself is a "homework", if you want to get good grades, you must not do without enough study. Before choosing hyaluronic acid injections, consumers must first clarify their needs - is it precise shaping or simple filling? Want deep fill or shallow adjustments? Then combined with its own time, economy and other factors, comprehensive scientific judgment.
There is nothing wrong with loving beauty, but the risks need to be clear
Hyaluronic acid products have been proven to be safer, why are tragedies caused by them common? In fact, the operator's technique, technique and even aesthetics will directly affect the final effect.
"Injecting hyaluronic acid cannot be absolutely safe, and there are certain risks." Li Xiaofang said that safety is related to injection site, injection depth, aseptic operation, etc. If the operator's anatomical structure is not well mastered, it is easy to inject hyaluronic acid into the blood vessels, causing local vascular embolism. Tear trough and nose injections may cause blindness, and temporal injections may cause cerebrovascular embolism, brain tissue necrosis, cerebral edema, and even cause life-threatening problems. In addition, if the injection environment is not strictly sterile, it is easy to cause infection, resulting in complications.
According to CCTV reports, in February this year, a post-90s girl bought 6 bottles of hyaluronic acid from the owner of a clothing store she met by chance, and received the owner's forehead filling in a hotel, but due to improper operation, the hyaluronic acid that should have been injected into the epidermis was injected into the blood vessels, directly causing central artery blockage. Although her life was eventually saved by the hospital, the girl was left with a lifelong disability.
In the mainland, injection operations are medical acts, and only doctors with a medical practitioner qualification certificate or a medical assistant with a medical assistant qualification certificate can operate it. However, at present, the medical beauty industry lacks strict supervision of practitioners' qualifications, and the overall market is mixed, and a large number of unsupervised illegal institutions have emerged, making it difficult for consumers to make timely and scientific identification, and there are serious safety risks.
A medical beauty practitioner who did not want to be named told reporters that the price of hyaluronic acid products in high-end beauty institutions will vary greatly, partly because of expert resources: "Experienced experts can use the least amount to achieve the maximum effect, but some dosage is more expensive, which has a lot to do with personal habits and experience." The reporter also found in the visit that in addition to the price difference of the hyaluronic acid brand, more and more beauty institutions have begun to use the doctor team as a bargaining chip for publicity, and it is difficult for consumers to distinguish the authenticity.
▲On the official website of the Health Commission, consumers can directly inquire about relevant qualifications
In this regard, Xie Fang, a practicing physician at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences, said that consumers can check on the official website of the Health Commission before choosing medical beauty, "One is to be able to inquire about the practice institution to see whether it has been officially filed and approved by the Health Commission, and how many levels of hospital it is; One is to check with a practicing doctor to confirm what the doctor's specialty is, his level, and which hospital he is practicing in. She said.
Before preparing to inject hyaluronic acid, consumers need to choose a legally marketed regular product, a regular medical institution with corresponding qualifications, and a doctor with corresponding practice qualifications to inject. And pay careful attention to information such as contraindications, complications, precautions, etc. People with bleeding diseases, severe cardiopulmonary or other diseases, local infections, and unstable psychological status are also not suitable for hyaluronic acid injection.
"With the improvement of everyone's living standards, the demand for the medical beauty industry has increased, but it has developed relatively late and relatively fast, and at this time some illegal individuals or institutions have seen profit opportunities and carried out medical plastic surgery," Zhao Zhenmin, director of plastic surgery at Peking University Third Hospital, also admitted in a focus interview that this practice not only caused patients to lose money, but also physical and mental health.
There is no good or evil in technology, and there is nothing wrong with loving beauty. Rationally looking at appearance and learning to be moderate may be a must for everyone on the road to beauty.
TIPS:
In 2021, the National Health Commission approved hyaluronic acid as a new food raw material, which can be applied to ordinary food additions, and some merchants took the opportunity to claim that oral hyaluronic acid can "eat water and light skin".
But in fact, hyaluronic acid, as a macromolecular polysaccharide, will be rapidly decomposed after oral administration into the gastrointestinal tract, transported through the blood, and it is difficult to reach the skin directly.
Produced by: Popular Science Central Kitchen
Executive Producer: Beijing Science and Technology News | Beike Media
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