Frequently Asked Questions
Decoria®
We consider a dermal filler as pure if it contains minimal amounts of synthetic additives.
Our gel technology SHAPE™ (Smart Hyaluronic Acid PurE Technology) utilises the natural and entangled form of the hyaluronic acid (HA) molecule. This means that we just have to add minimal amounts of the cross-linking agent BDDE (1,4-butanediol diglycidyl ether) to create durable gels. Only 1% of the HA molecule is modified in the Decoria® dermal fillers, making Decoria® the purest HA dermal filler range.
The following indications are recommended for the Decoria® dermal fillers:
Decoria® Voluma: Cheeks, nasolabial folds, marionette lines
Decoria® Essence: Lips and fine lines
Decoria® Intense: Cheeks/mid-face
Decoria® Intense Strong: Jawline, chin
The Decoria® dermal fillers may only be used as an intradermal implant by properly trained, qualified physicians or authorised staff members in accordance with national legislation.
Please read more in the Instructions For Use (IFU) that can be downloaded on the Decoria® product pages.
Safety data can be found in the Decoria® Instructions For Use (IFU) where you will find information about warnings and precautions, contraindications and patient information.
The Decoria® dermal fillers may only be used as an intradermal implant by properly trained, qualified physicians or authorised staff members in accordance with national legislation.
See Decoria® product pages to download the IFU.
When there is a high degree of modification, the body may perceive the filler gel as a foreign and there is a higher risk of an immunological reaction.*
Highly cross-linked gels may also be more difficult to dissolve with hyaluronidase.*
The degree of modification varies substantially between filler brands, from the very low degree of 1% that characterises all Decoria® fillers to 8% or more.*
*Wu G.T. et al., Hyaluronic Acid Basics and Rheology, Facial Plast Surg Clin North Am. 2022 Aug;30(3):301-308.
The hyaluronic acid (HA) molecules in dermal fillers are cross-linked to increase the durability of the gel. The most common cross-linking agent is 1,4-butanediol diglycidyl ether (BDDE)*, which is also used to produce all Decoria® fillers.
When a filler gel degrades, BDDE breaks down into harmless byproducts or into byproducts that are identical to substances already found in the skin.*
*De Boulle K et al., A Review of the Metabolism of 1,4-Butanediol Diglycidyl Ether–Crosslinked Hyaluronic Acid Dermal Fillers, Dermatol Surg. 2013 Dec; 39(12): 1758–1766.
All Decoria® dermal fillers are based on bio-fermented hyaluronic acid (HA) where the natural entangled form of the HA molecular strands is preserved. Thereby, only a minimal number of cross-links is needed to produce durable gels.
When instead ´straight´ HA molecular strands are utilised, more cross-links are needed to make a durable filler gel.
The degree of modification is also dependent on the number of failed links, where there is only a ‘pendant’ on an HA molecule and no effective linking. Pendant modifications do not contribute to filler durability.*
*Wu G.T. et al., Hyaluronic Acid Basics and Rheology, Facial Plast Surg Clin North Am. 2022 Aug;30(3):301-308..
The durability of Decoria® Voluma for cheekbone enhancement has been evaluated in a large 300-day study that showed significant and lasting results.*
90 patients were treated with a maximum of 5 mL. 3D imaging was used to evaluate projection in cm3. Results were ranked from -1 worse to 0 identical, +1 improved, +2 much improved.
Cheekbone projection improved to 1.18 at day 7 (p < .001) and remained significantly improved by day 300 at 0.78 (p = .003).
*Torres S., Zygomatic Augmentation through Curved Cannulas with the Use of a New Stabilized Hyaluronic Acid Dermal Filler (Decoria® Voluma, Bohus BioTech AB, Sweden, EC): 10 Months Follow Up, Medwin Publishers 2018 Nov. 23; Vol 3, Issue 3..
Minivisc® Plus
OVDs are sometimes considered commodities in cataract surgery, with one cohesive OVD being interchangeable with another. However, that is not always the case. Providing an optimal intraocular space for surgeons and patient comfort and easy aspiration at the end of the surgery is vital when choosing the right OVD. Reducing operation time and ensuring no rise in intra-ocular pressure (IOP) are also crucial.
The capacity of an OVD to remain intact and to adhere to itself - its cohesiveness - is essential to create and maintain the intraocular space. For easy withdrawal, a long molecular structure is needed.
How the gel is manufactured also affects its rheology, with many different technologies available to produce bio-fermented viscoelastics. Our expertise at BOHUS has allowed us to create Minivisc® Plus, a market-leading bio-fermented cohesive OVD with exceptional cohesivity and molecular weight (3-4MDa).
Minivisc® Plus is a highly cohesive OVD, which is the result of a combination of a high concentration of HA (1.4%), its high molecular weight (3-4mDa), and BOHUS’s proprietary manufacturing process.
The shear viscosity rates for Minivisc® Plus and MicroVisc, BOHUS’s legacy, animal-derived product (no longer in production) show their rheology to be almost identical, with high viscosity at low shear rates, but they are also pseudoplastic, being more dispersive at higher rates.
These properties combine to make Minivisc® Plus an ideal OVD for creating and maintaining adequate intraocular space and stabilising ocular tissue during eye surgery, especially during capsulorhexis and IOL implantation.
Minivisc® Plus owes its viscosity to the high HA concentration of 1.4%, its high molecular weight, and BOHUS’s proprietary manufacturing process. Every stage in the production process impacts the gel structure, and molecular weight is measured for each specific batch, post-sterilisation. Minivisc® Plus has a molecular weight of 3-4 MDa.
General FAQs on HA
Hyaluronic acid is a naturally-occurring molecule in the human body that plays crucial roles in maintaining tissue hydration, and in a range of cellular processes. Due to their biocompatibility, biodegradability, non-toxicity, and non-immunogenicity, HA-based products have been developed over the last fifty years for a range of biomedical applications. HA applications now cover many fields, ranging from cosmetic formulations to visco-surgery, ophthalmology, orthopaedic surgery, rheumatology, tissue regeneration, and even targeted cancer therapy. This broad range of applications is possible due to the specific properties of HA, based on its structure and molecular weight.
Iaconisi, G. N. et al. (2023). Hyaluronic Acid: A Powerful Biomolecule with Wide-Ranging Applications-A Comprehensive Review. International journal of molecular sciences, 24(12), 10296. https://doi.org/10.3390/ijms241210296
https://pubmed.ncbi.nlm.nih.gov/?term=hyaluronic+acid+patient+safety (accessed 21 December 2023)Hyaluronic acid was first extracted from animal tissues such as rooster combs, and bovine vitreous humor. However, challenges with the use of animal tissue, such as high costs, low yields, variability, and ethical concerns, as well as issues with immune response and hyaluronidase degradation, led to the development of microbial production methods as an alternative. Bacterial fermentation (bio-fermentation) methods have thus gained in popularity, with a focus on optimising HA production for high-quality, efficiency, and cost-effectiveness. So called bio-fermented HA has been proven in the existing major application areas, in aesthetics, ophthalmics and orthopaedics.
Meyer, K.; Palmer, J.W. The polysaccharide of the vitreous humor. J. Biol. Chem. 1934, 107, 629.
Sze, J. H., Brownlie, J. C., & Love, C. A. (2016). Biotechnological production of hyaluronic acid: a mini review. 3 Biotech, 6(1), 67. https://doi.org/10.1007/s13205-016-0379-9
Iaconisi, G. N. et al. (2023). Hyaluronic Acid: A Powerful Biomolecule with Wide-Ranging Applications-A Comprehensive Review. International journal of molecular sciences, 24(12), 10296. https://doi.org/10.3390/ijms241210296BOHUS was one of the first companies in the world to explore the water-binding qualities of hyaluronic acid, and continues to lead innovation and development of products containing HA for medical and aesthetic purposes.
For 30 years, we have served our partners and customers across ophthalmics, orthopaedics, and aesthetics. Drawing from this heritage, our in-depth production expertise and technological know-how position us as a leading developer and manufacturer of high-quality hyaluronic acid products in Europe.
BOHUS products are routinely used in aesthetic enhancement, cataract surgery and the treatment of osteoarthritis. With a large and growing network of international partners, we sell to hospitals, clinics and physicians in over 60 markets worldwide. Our vision is to revolutionise the HA market by delivering higher quality products, with the most sustainable processes, at exceptional value.