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What is Desirial?

Desirial is an injectable gel designed by Laboratories Vivacy that is intended for vaginal rejuvenation procedures. It is composed of a cross-linked sodium hyaluronate gel integrated with mannitol. While sodium hyaluronate hydrates and volumises the skin, mannitol ensures good antioxidant actions by scavenging harmful free radicals. Mannitol also serve as an anti-inflammatory agent to reduce the severity of post-injection reactions. There are 2 versions of fillers in this range and are differentiated by the concentration of hyaluronic acid:

1. Desirial contains 19mg/mL of cross-linked sodium hyaluronate gel integrated with mannitol and is supplied in a 1mL syringe. Each box comes with 2 preloaded syringes, 2-27G½” disposable needles, 2-30G½” disposable needles, and a device information manual.
2. Desirial Plus contains 21mg/mL of cross-linked sodium hyaluronate gel integrated with mannitol and is supplied in a 1mL syringe. Each box comes with 1 preloaded syringe, 2-27G½” disposable needles, 1-18G cannula, 1-25G needle, and a device information manual.

Both versions come in sterile packaging and must be stored in a clean and dry place with a temperature ranging from 2℃ to 25℃.

What is it used for?

Not to be confused with vaginoplasty, which involves surgery, vaginal rejuvenation is a non-surgical alternative to improving the functional and aesthetic aspects of the vagina.

When the vagina is healthy, it self-regulates the pH and secretes adequate amounts of lubricating discharge. Since it is made of smooth muscles, the vagina is able to revert back to its original shape after intercourse. Nevertheless, the vagina is easily affected by numerous factors like health conditions, age, and hormone levels, to name a few.

With age, a lot of changes occur in the vagina. More often than not, the labia majora (the outermost tissue folds surrounding the vagina) undergo tissue loss and lose their aesthetic appeal. This alteration is very obvious especially in patients who have given birth. Besides that, menopause marks a steep decline in important hormones like oestrogen. A lack of oestrogen leads to vulvovaginal atrophy, in which the tissue lining in the vagina becomes thinner, drier, and less elastic. As a result, the vagina is extremely fragile and becomes prone to pain, injuries, and infections.

For these reasons, Desirial is ideal for rehydrating the regions of the vagina affected by bothersome dryness; Desirial Plus is perfect for reshaping the vagina after the loss of volume and deterioration of its appearance.

How does this injectable gel work?

Desirial is composed of synthetic cross-linked hyaluronic acid to deliver much-needed hydration and volume to dry and thin areas of the vagina. The hyaluronic acid is extracted and purified via a biofermentative process and is processed using InterPenetrated Cross-linked Networks IPN-Like Technology. This proprietary technology integrates the antioxidant mannitol into monophasic hyaluronic acid gel. So, the use of a chemical reticulating agent––1,4-Butanediol diglycidyl ether (BDDE)––is greatly reduced. As a result, the monophasic hyaluronic acid gel instantly moisturises and plumps up the tissues.

Mannitol is a type of sugar alcohol found abundantly in fruits and vegetables. When the skin is injected, inevitable inflammatory reactions occur, which can be exacerbated by free radicals. So, mannitol molecules exhibit effective antioxidant actions by scavenging these reactive toxins to reduce post-injection gel degradation. Hence, the administered gel can withstand premature disintegration and provide durable improvements––hydration and volume––for an extended period of time. 

How to inject it

Though this vaginal rejuvenation procedure does not involve invasive surgery, it must still be conducted with strict adherence to aseptic standards. Also, it is extremely important that only legally certified physicians specialising in vaginal rejuvenation procedures safely conduct this treatment. Just with any other medical procedures, patients’ medical information should be thoroughly reviewed (e.g. existing conditions, presence of allergies, drugs and supplements taken). Patients should also be made aware of precautions, contraindications, adverse reactions and aftercare methods during the initial consultation session.

Prior to the injection process, ensure that the filler is still in its original sterile packaging and within its shelf life. Assemble the medical device correctly by securing a suitably sized needle on the Luer lock connection of the prefilled syringe. Assess the patient’s need for pain management and administer a local anaesthetic if necessary. If it is the labia majora region that is being correcting, inject the gel via subcutaneous injections using an 18G cannula. The best technique is linear retrotracing. Tf the patient being treated suffers from Female Sexual Dysfunction (FSD), inject the filler in the vaginal mucous membrane using a 27G½” needle. 

Once you are satisfied with the correction, gently massage the treated areas. Discard any remaining gel and used needles responsibly to reduce risk of cross-contamination. Pay extra caution to not inject more than 20mL of the hyaluronic acid gel in a patient per year. Read the device information manual for detailed directions for usage.

How long does this filler last?

Due to its unique IPN-Like Technology, Desirial injectables are able to deliver long-lasting performance. Patients get to enjoy the hydrating and volumising actions of filler for a minimum of 6 months or even up to 1 to 2 years. The filler is completely biodegradable and will be absorbed into the surrounding tissues after some time. The remanence time greatly varies based on the patients’ age, and lifestyle choices.

Is this product safe?

Yes, Desirial is a safe, Class 3 medical device that was awarded the CE marking 0499, which attests to its safety and high quality. The hyaluronic acid is derived biotechnologically from a tightly-regulated bacterial fermentation process. After extraction, the molecules are processed and purified to be free of any potentially dangerous contaminants. That being said, there are certain patients who may not be qualified for the treatment, including:

• Not for use in patients who are allergic/hypersensitive to any of the components (e.g. sodium hyaluronate, mannitol);
• Not for use in patients who have a tendency to develop hypertrophic scarring;
• Not for use in areas other than the subcutaneous layer of the labia majora or mucous membrane of the vagina;
• Not for use in areas affected by inflammation or infections (e.g. thrush, herpes, papilloma)
• Not for use in paediatric patients;
• Not for use on pregnant or lactating patients.

Read the device information manual for a detailed list of contraindications.

Desirial side effects

Patients may experience some side effects post-treatment.

Common side effects:

• Temporary redness
• Swelling
• Itching
• Discolouration
• Pain and tenderness

These mild reactions are contained within the injection sites and will resolve within a few days.

Serious side effects:

• Hardening of injected sites
• Slight bleeding
• Blood clots
• Difficulty urinating

Educate clients on all the possible symptoms that may occur. Inform them to get immediate medical help if any of the symptoms last longer than a week. Read the device information manual for a detailed list of side effects.

What is it made of?

Desirial is a range of injectable gels intended for vaginal rejuvenation procedures. It is composed of non-animal, cross-linked sodium hyaluronate gel integrated with mannitol. Sodium hyaluronate hydrates and volumises the skin while antioxidant mannitol reduces the severity of post-injection reactions by scavenging harmful free radicals. After the procedure, vaginal tissues are adequately hydrated and sculpted for better functionality and aesthetic appearance.