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Macdermol® products are made with stabilised hyaluronic acid produced in Europe, with the highest level of purity available in the industry today, and cross-linked through a proprietary process making it possible to use little or no chemical agent.
To improve the duration of HA in vivo, a common method is to form a hydrogel by covalently cross-linking the HA polymer chains into a three-dimensional network [5,6]. HA hydrogels, formed by cross-linking, have become important for many medical and esthetic applications.
Unfortunately, these cross-linking processes involve chemical agents such as 1,4-butanediol diglycidyl ether (BDDE), formaldehyde, divinyl sulfone, 1,2,7,8-diepoxyoctane etc. which have been shown to have toxic and mutagenic activities [7-10].
This use of cross-linking agents can impair the biocompatibility with risk in both short and long-term applications [11], especially regarding the incidence of granulomas after repeated injections and large injected volumes [12]. Moreover, this type of modification can affect the ease of injectability of the HA hydrogel as well as the natural viscoelastic and biological properties of the HA molecule which will have a more rigid structure, a lower water-binding capacity, and a lower capacity on the production of extracellular matrix components [13].
Such adverse events and disadvantages are avoided with the use of a physical cross-linking instead of a chemical one [14,15].
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