GOURI away from the face — neck, eyes, hands

What surprised us in building this table was the order. Normally the scope narrows as you go data → approval → guidance → clinic. Here the manufacturer’s own guidance is the narrowest (face only) and the manufacturer’s KOL article is the widest (as far as the knees). And nothing published supports the widest end. That is the basis on which you can ask, when an area is proposed to you, “is there data for this site?”

That the total human observation is 33 people is a number this site repeats whenever GOURI comes up. In a discussion of treatment areas it carries a slightly different meaning — because it means all 33 were treated on the face. Away from the face, the human data is not sparse; it is absent.

“It can go shallow, so it suits thin skin” is a hypothesis. The liquid form has no particles and is designed to spread shallow and wide, so the reasoning that it should favour thin-skinned areas is mechanistically understandable. But mechanistically plausible and verified in people are different things. We found no human data supporting that reasoning.

The neck is known as an area that injectables must treat as a separate case. The skin is thin, subcutaneous fat is scarce, and it moves constantly as you speak, swallow and turn your head. There is more room than on the face for material placed shallowly to clump or show through. That is anatomy — but no data verifies any of it for liquid-form polycaprolactone.

What is informative is the regulatory history of a different class. For CaHA (Radiesse), the US FDA approval history contains no neck indication; the neck is in fact named as a non-approved area. The décolletage, by contrast, was approved on 31 March 2026, dilution method and all. The detail is in how far CaHA has actually been verified.

So what we can say about the neck is this. There is no published report of treating the neck with liquid PCL, the manufacturer’s own guidance files the neck under “collecting data”, and in other classes the neck is sometimes left outside the approved scope. None of that means neck treatment is impossible. It means the basis is the injector’s judgement rather than an approval or a study.

The manufacturer’s technique guidance contains a line for 2 points when treating the eye area alone. Yet we found no published study of the eye area. The 30-person pilot treated the middle third of the face, and no study evaluated the under-eye separately.

The under-eye warrants caution for other reasons too. The skin is the thinnest on the face, vessels run superficially, and material showing through or looking puffy happens more readily there than elsewhere. The general considerations for under-eye treatment are in the tear trough — what to put in, and the option of putting nothing in.

“The manufacturer’s guidance gives a point count, so it must be verified” does not follow. Technique guidance describes how to place the product; it does not assert that efficacy and safety were established in that area. They are two different documents.

This table does not say “Radiesse is better”. The two materials differ in mechanism and in plane, and no study has compared them on the hands. All the table says is that for the same area, one has an approval and data behind it and the other does not. If you are considering treatment on the hands, it is better to choose knowing that difference. The evidence and limits for CaHA are in how far CaHA has actually been verified, and the product document is Radiesse.

The manufacturer’s KOL article lists the décolletage and the thin, dry skin of elbows and knees among the indications. For these areas we found not a single published report on liquid-form polycaprolactone.

On technique, the same article says only that “2 ml of GOURI was injected through the same entry points in a retrograde fashion”; point counts by area, plane, choice of needle or cannula and volume per point are not stated. The author is described as an “international GOURI KOL”. We are not saying the article is wrong — we are saying that it is expert opinion, not a trial report.

Do not judge from before-and-afters and testimonials. Information about a new area usually circulates first as treatment cases and photographs. Why that cannot serve as evidence is set out in how to read reviews. It is also why this website does not present testimonials or before-and-after photographs as proof of effect.

Using a medical device in an area or a manner not written into its approved intended use is commonly called off-label use. That is not in itself wrong — medicine has a space that runs on the clinician’s judgement. But what changes is clear.

• The source of the evidence changes. Inside the approved scope, the dossier submitted for approval stands behind the treatment; outside it, the injector’s experience and judgement are the evidence.
• There is nothing to measure against. For that area, no standard exists for number of sessions, volume, plane or duration.
• If an adverse event occurs, there is nothing to consult. Liquid PCL has 33 people observed on the face, and zero away from it.

So we are not saying “do not do it”. We are saying decide while knowing that this area rests on judgement rather than on approval and data. And you are entitled to ask whose judgement it is, and how much of that area they have treated. The difference between domestic and export-only licensing is in what separates a domestic licence from an export-only one, and how to check a licence number is in what one licence number tells you, and what it does not.

If an area away from the face has been proposed to you, these four questions make the conversation precise.

• “Is there published data for this area?” — for liquid PCL, the accurate answer at present is “no”.
• “May I have the licence number, and does the intended use include this area?” — under Article 20 of the Medical Devices Act the number is printed on the box.
• “What happens if there is a problem in this area?” — this product cannot be reversed with hyaluronidase. Asking for the plan is reasonable.
• “How many sessions, and how long does it last?” — even on the face, the longest observation in people is 6 months. Away from the face there is nothing to answer with.

The full set of pre-treatment considerations is in before a GOURI injection — what this product changes, and the course over time is in GOURI — from the day of the injection to months later.

What we most want to leave you with is not that you should avoid the neck or the hands. It is that the manufacturer itself wrote “face only” and said the hand and neck data is still being gathered, and that the document recommending those areas is a key opinion leader’s article rather than a trial. Choose knowing those two things and it becomes clear what your decision is resting on.

Written and reviewed by Lee Chi-Hak, MD, medical director of Miso Clinic in Daegu, South Korea. Every study cited above is given together with its design, its size and the limitations the authors themselves recorded, and where we could not find data, we have said that we could not find any.