Preface: The New Paradigm in Facial Rejuvenation: Soft Tissue Fillers 2015 ix

Corey S. Maas

Cosmetic Fillers: Perspectives on the Industry 417

Steven L. Basta

The cosmetic filler industry has evolved substantially over the last 30 years. The market is characterized by multiple fillers and a competitive dynamic among major aesthetics companies. Marketing in the United States and Europe has been different owing to regulatory constraints. Differences have led to more rapid growth in the European market. The US market has evolved owing to growth of major companies with multiple product portfolios and leverage in consumer promotion and aesthetics office marketing owing to scale. The evolution of the filler market will include new materials, injection techniques, and facilitation devices, and new areas of injection.

Cosmetic Fillers: Perspectives on the Industry 417

Steven L. Basta

The cosmetic filler industry has evolved substantially over the last 30 years. The market is characterized by multiple fillers and a competitive dynamic among major aesthetics companies. Marketing in the United States and Europe has been different owing to regulatory constraints. Differences have led to more rapid growth in the European market. The US market has evolved owing to growth of major companies with multiple product portfolios and leverage in consumer promotion and aesthetics office marketing owing to scale. The evolution of the filler market will include new materials, injection techniques, and facilitation devices, and new areas of injection.

The Hyaluronic Acid Fillers: Current Understanding of the Tissue Device Interface 423

Jacqueline J. Greene and Douglas M. Sidle

This article is a detailed summary of the device tissue interface regarding cosmetic injectable fillers, specifically focusing on hyaluronic acid fillers. Hyaluronic acid- injectable fillers are used extensively for soft tissue volumizing and contouring. Many different hyaluronic acid-injectable fillers are available on the market and differ in terms of hyaluronic acid concentration, particle size, cross-linking density, requisite needle size, duration, stiffness, hydration, presence of lidocaine, type of cross-linking technology, and cost. Although much is known about how the devices interact with biologic tissues and how they produce their effects, they continue to be actively studied for tissue engineering purposes. The biomechanical and biochemical effects of HA on the local microenvironment of the injected site are key to its success as a soft tissue filler. Knowledge of the tissue device interface will help guide the facial practitioner and lead to optimal outcomes for patients.