Tissue Fillers for the Nasolabial Fold Area: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Tissue fillers injections remain to be one of the most commonly performed cosmetic procedures. The aim of this meta-analysis was to systematize and present available data on the aesthetic outcomes and safety of treating the nasolabial fold area with tissue fillers. We conducted a systematic review of randomized clinical trials that report outcomes concerning treatment of nasolabial fold area with tissue fillers. We searched the MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, Scopus, Cochrane Controlled Register of Trials, CNKI and Web of Science databases. Primary outcomes included aesthetic improvement measured using the Wrinkle Severity Rating Scale score and Global Aesthetic Improvement Scale. Secondary outcomes were incidence rates of complications occurring after the procedure. At baseline, the pooled mean WSRS score was 3.23 (95% CI: 3.20–3.26). One month after the procedure, the pooled WSRS score had reached 1.79 (95% CI: 1.74–1.83). After six months it was 2.02 (95% CI: 1.99–2.05) and after 12 months it was 2.46 (95% CI: 2.4–2.52). One month after the procedure, the pooled GAIS score had reached 2.21 (95% CI: 2.14–2.28). After six months, it was 2.32 (95% CI: 2.26–2.37), and after 12 months, it was 1.27 (95% CI: 1.12–1.42). Overall, the pooled incidence of all complications was 0.58 (95% CI: 0.46–0.7). Most common included lumpiness (43%), tenderness (41%), swelling (34%) and bruising (29%). Tissue fillers used for nasolabial fold area treatment allow achieving a satisfying and sustainable improvement. Most common complications include tenderness, lumpiness, swelling, and bruising. Level of Evidence II "This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266."

Invited Response on: “Tissue Fillers for the Nasolabial Fold Area–A Systematic Review and Meta-Analysis of Randomized Clinical Trials”

“…We sincerely appreciate the opportunity to respond to the letter by Dr. Sadhegi et al concerning our systematic review and meta-analysis [1]. Hopefully, this will allow an enhanced discussion about the role of vascular anatomy in nasolabial fold correction by tissue fillers.…”

The COVID‐19 pandemic and its impact on esthetic dermatology

“…Hyaluronic acid (HA) is a natural polysaccharide and the most commonly used tissue filler for dermal rejuvenation because of its better safety profile and the capability to be reversed by hyaluronidase enzymes. 30 The HA technologies, per se, are various, each with different viscosity and duration of lasting. The ones with more viscosity and durability are more susceptible to develop inflammatory reactions.…”

A systematic review onCOVID‐19 vaccination and cosmetic filler reactions: A focus on case studies and original articles

“…Tissue fillers are among the most popular non‐surgical aesthetic procedures worldwide and are currently being used for facial and non‐facial areas. 1 , 2 There exist different types of tissue fillers such as hyaluronic acid (HA), calcium hydroxyapatite (CaHA), polymethylmethacrylate (PMMA), Poly‐L‐lactic acid (PLLA), and collagen‐based products. It is believed that an ideal dermal filler should be safe, non‐allergenic, non‐immunogenic, non‐carcinogenic, non‐migratory, cost‐effective, and stable for the desired time within the target tissue.…”