Neauvia Stimulate 1x1ml

• Cross-linked hyaluronic acid: 26 mg/ml.
• Calcium hydroxyapatite (CaHA): present at low concentration; the manufacturer does not publish the exact value.
• Cross-linker: PEGDE (polyethylene glycol diglycidyl ether).
• Glycine and L-proline in phosphate buffer solution.
• No anaesthetic: the formulation does not contain lidocaine.
• Rheological profile: medium/high extrusion force. In the characterisation by Zerbinati et al. (Polymers 2021;13:948), the 26 mg/ml sample with CaHA of this platform showed an elastic modulus G′ of 164.67 ± 2.94 Pa at 25 °C. The study identifies the samples by composition and not by trade name.

Calcium hydroxyapatite (CaHA) at low concentration. Stimulate is the only cross-linked reference in the range that incorporates calcium hydroxyapatite microparticles dispersed in the PEGylated HA matrix. The manufacturer does not publish the percentage of CaHA and describes it only as "low concentration". This composition changes the category of the product: in addition to providing volume, the CaHA acts as a mechanical stimulus on the fibroblast, a mechanism described in the literature for calcium hydroxyapatite implants. Zerbinati et al. evaluated in vitro the biosafety of PEG cross-linked hyaluronic acid with CaHA microparticles at low concentration (Open Access Maced J Med Sci 2018). It should not be confused with high-load CaHA implants of the Radiesse type, whose hydroxyapatite concentration and behaviour are different.

Cross-linking with PEGDE. Neauvia uses polyethylene glycol diglycidyl ether (PEGDE) as its cross-linking agent, instead of the BDDE used by most HA fillers on the market. The manufacturer calls this platform Smart Crosslinking Technology and bases the safety profile of the range on it: no pathological inflammatory reactions detected, no cytotoxic activity, no cross-linker residues after complete degradation of the implant, and reversibility of the filler with hyaluronidase.

Objective reading of the data. PEG is a well-established polymer in pharmaceutical use, and the available publications on the PEG-HA hydrogels from Matex Lab (Zerbinati et al.) describe in vitro biocompatibility and a degree of cross-linking between 2.8 % and 6.2 %. The exact PEGDE concentration is protected by patent and is not published by the manufacturer. To date there is no direct comparative trial of PEGDE versus BDDE with a primary clinical endpoint, so the advantage should be understood as a difference in cross-linking chemistry supported by physicochemical and in vitro data, not as a demonstrated clinical superiority.

Glycine and L-proline. Both proteinogenic amino acids are added to the phosphate buffer solution to adjust the viscoelastic properties of the gel and its swelling resistance, with the aim of controlling the water uptake of the hydrogel in the phase following implantation.

The entire range shares the same formulation backbone: hyaluronic acid of biotechnological origin cross-linked with PEGDE (polyethylene glycol diglycidyl ether), buffered in phosphate solution and enriched with glycine and L-proline. The difference between references lies in the HA concentration, the resulting rheology and the intended injection plane, not in the cross-linking chemistry. Hydro Deluxe is the only non-cross-linked reference; Stimulate is the only one that incorporates calcium hydroxyapatite in the gel.

Biodegradable hyaluronic acid hydrogel with calcium hydroxyapatite, indicated to restore lost volume of the soft tissue of the face.

• Volumetric restoration of the mid third of the face
• Malar region and facial contour
• Areas with loss of structural support and of dermal density

The manufacturer limits the injection area to the face and the plane to the subdermis and/or supraperiosteal level. It is not positioned as a superficial revitalisation product for the neck, décolletage or dorsum of the hands; for skin quality treatment the range offers Hydro Deluxe.

• Injection plane: subdermis and/or supraperiosteal.
• Area: face.
• Needle: the pack includes a needle/cannula guide; the manufacturer does not publish the gauge for this particular reference.
• Duration: 6 months mean degradation time according to manufacturer data.
• Deep bolus deposit or retrograde injection with a cannula; prior aspiration in accordance with standard clinical protocol.
• Integrated by the manufacturer into its synergistic mid-face protocol, in combination with lower-density references.

The pack contains: 1 pre-filled syringe of 1.0 ml, needle/cannula guide, package leaflet and traceability labels.

• Sterile pre-filled syringe, ready for use.
• Single-use product. Do not reuse or re-sterilise.
• Store under the conditions indicated on the pack, protected from direct sunlight.
• Do not use after the expiry date shown on the pack.
• The traceability labels supplied must be attached to the patient record.

The manufacturer restricts use to physicians acting in accordance with local legislation and trained in hyaluronic acid filler injection techniques.

Must not be applied in the case of: known hypersensitivity to any of the components of the product; active skin infection, inflammation or lesion in the treatment area; pregnancy and breastfeeding; patients under the age of majority.

Individual assessment: autoimmune disease or immunosuppressive therapy; tendency to hypertrophic or keloid scarring; anticoagulant or antiplatelet therapy; presence of permanent implants in the area.

Do not inject intravascularly. Sterile single-use product: do not reuse or re-sterilise; discard the syringe and the needle after the procedure.

The full contraindications, warnings and possible adverse effects are listed in the package leaflet accompanying the pack and must be consulted before each application.