Amalian is a range of dermal fillers that are composed of completely synthetic and fully degradable monophasic and biphasic hyaluronic acid. These fillers are formulated by a renowned S&V Technologies, a renowned German pharmaceutical company that has been manufacturing implantable medical products for the last two decades. There are two major collections of fillers under the Amalian brand: LT, the monophasic range, and Expert, the biphasic range. These two lines differ in terms of the gel processing technology used and the gel texture itself. As for the Juvederm range of fillers, it is made of ultra-pure hyaluronic acid molecules that are derived from biofermentation and are processed into injectable implants with a monophasic gel texture. Just like Amalian brand, Juvederm is also composed of two ranges: the Vycross and Ultra collections, which are differentiated by the type of processing technology used. Juvederm is a product of Allergan.
Are the ingredients the same?
The hyaluronic acid molecules in both these brands are derived from biofermentation and are completely free from any potentially dangerous animal components. The molecules are then thoroughly purified to get rid of any bacterial endotoxins.
The monophasic Amalian fillers—Amalian LT Smoothline, Amalian I LT Active, Amalian II LT Intense, and Amalian LT Beauty Lips—are softly cross-linked, and the formulation (e.g. viscoelasticity, strength of hyaluronic acid, etc.) of each monophasic implant is then fine-tuned to suit individual treatment areas. Amalian Balance is the only monophasic filler that is not cross-linked: it is designed to be non-cross-linked so that it can instantly hydrate and rejuvenate skin affected by premature aging signs via the mesotherapy technique.
On the other hand, the biphasic Amalian implants—Amalian I Expert Premium, Amalian II Expert Effect, Amalian III Expert Volume, and Amalian Lips Expert—are designed using patented Core-In-Shell (CIS) Technology. This contemporary technology helps to form a stable core made of highly cross-linked hyaluronic acid that acts as a protective shell. This stable core shields the inner long chains of non-cross-linked hyaluronic acid from being disintegrated prematurely by hyaluronidase, a naturally-occurring enzyme that gradually metabolizes hyaluronic acid molecules. As a result, biphasic Amalian implants are able to last longer in the skin due to their highly viscoelastic gel texture.
As for monophasic Juvederm fillers, after the hyaluronic acid molecules are derived via biofermentation and are purified, as mentioned before, they are processed with either Hylacross or Vycross technologies. The former involves reticulating a high proportion (90%) of low-molecular-weight hyaluronic acid molecules with a low proportion (10%) of high-molecular-weight hyaluronic acid molecules. This results in extremely malleable injectable implants—such as Juvederm Volite, Volbella, Volift, and Voluma—that are highly cohesive and able to provide smooth-looking results. Most importantly, the high concentration of low-molecular-weight hyaluronic acid molecules reduces the attraction of water from the surrounding tissues, resulting in a lower risk of post-injection swelling. On the other hand, Juvederm Ultra fillers, which are Juvederm Hydrate, Ultra Smile, Ultra 2, Ultra 3, and Ultra 4, are processed via Hylacross Technology and have smooth consistencies without a granular texture.
How does the efficacy of monophasic filler compare to biphasic fillers?
Though there is much debate over the clinical effectiveness of monophasic-textured hyaluronic acid-based injectable fillers versus its biphasic-textured counterparts, one is not definitively better than the other. Rather, the different physical properties of these aesthetic implants make them better suited to correct different clinical indications. Monophasic implants are composed of a homogenous, or single phase, of hyaluronic acid gel and have poorer spreadability yet superior cohesivity. As for biphasic implants, they exist in two phases in which the hyaluronic acid microspheres are suspended uniformly in a non-cross-linked hyaluronic acid gel that acts as a carrier. Biphasic fillers tend to have better spreadability. Both Amalian and Juvederm implants will deliver intended aesthetic improvements if they are administered in the appropriate treatment areas with the optimal injection techniques recommended by the manufacturers.
Can Amalian and Juvederm fillers be administered concurrently with other dermal procedures?
It is best that Amalian and Juvederm fillers are not administered at the same time with other dermal procedures like laser therapy and chemical peel, as this could exacerbate and amplify undesirable side effects. These aesthetic procedures should be administered some weeks apart to allow for skin reactions to diminish and the skin barrier to be reestablished. That being said, the Amalian LT fillers can be administered on top of Amalian Expert fillers if patients require additional correction on the superficial layer of skin. The same can be done for Juvederm fillers; patients requiring more comprehensive rejuvenation can be treated with more than one type of Juvederm implants.
Can implantation of Amalian and Juvederm fillers interfere with any existing health problems?
Generally, hyaluronic acid-based fillers should not be injected in patients with certain disorders, such as disorders of hemostasis or coagulation, infections, active inflammatory dermatitis, or allergies. Failure to do so will affect the behavior of the filler in the tissues and cause untoward negative side effects. Not only that, these hyaluronic acid-based implants may appear as additional tissues when seen under medical imaging scans (e.g. X-ray, CT, MRI, etc.). Hence, patients must let their medical practitioners know about their history of dermal filler implantations to avoid misinterpretation of medical imaging scans.