French researchers led by Maryna Taieb, MD, compared two injection techniques to determine the efficacy of 13.5mg/g uncross-linked hyaluronic acid combined with 0.9% mannitol (Juvederm Hydrate) on skin hydration and elasticity. The study—which appears in the Journal of Cosmetic Dermatology (June 2012)—involved four centers and a total of 34 female subjects. Group one consisted of 27 patients injected using a depot injection technique. Group two included seven subjects who received superficial dermis injections using the picotage technique. The researchers observed “significant improvement” in hydration, anisotropy and skin roughness in group one, but reported “no significant improvement” in group two. At day 60, physician assessment of group one showed that more than 90% of patients were “improved/very improved.” Patient assessment among the same group showed that greater than 80% felt their skin was “improved/very improved” and 85% would undergo repeat treatments. In group two, 86% of patients were unhappy with the outcome and 83% would refuse to undergo repeat treatment.