Efficacy and safety of a new hyaluronic acid filler for nasolabial folds: A 52-week, multicenter, randomized, evaluator/subject-blind, split-face study

Efficacy of a New Hyaluronic Acid Dermal Filler on Nasolabial Folds Correction: A Prospective, Comparative, Double-Blinded Clinical Trial

BACKGROUND

Hyaluronic acid-based dermal fillers are the cornerstones of wrinkle correction and facial contour redefinition.

OBJECTIVE

To assess the efficacy and safety of ESTLF compared with RESL for the treatment of nasolabial folds (NLFs).

MATERIALS AND METHODS

In this prospective, split-face, randomized, investigator and subject-blinded trial, 45 subjects with moderate-to-severe symmetrical NLFs were randomized to ESTLF on one side of the face and RESL on the other side and were followed up for 9 months. The primary end point was change in WSRS score from the baseline to Month 1 (M1). Secondary end points included changes in WSRS score at other time points, aesthetic improvement, wrinkle volume quantification, adverse events, and local tolerance.

RESULTS

The efficacy difference between ESTLF and RESL at M1 was in favor of ESTLF (-0.16, CI, -0.28 to -0.03]), demonstrating its noninferiority. Considering other time points, significant differences were observed at 3 and 6 months for ESTLF, assessed with WSRS, GAIS, or NLF volume quantification. Both treatments were well tolerated.

CONCLUSION

ESTLF is effective and well tolerated for the treatment of NLFs.

Adverse Events Associated with Hyaluronic Acid Filler Injection for Non-surgical Facial Aesthetics: A Systematic Review of High Level of Evidence Studies

BACKGROUND

Hyaluronic acid (HA) dermal fillers are widely used in aesthetic medicine. While generally safe, potential complications can arise.

OBJECTIVE

This systematic review aims to identify and classify potential complications linked to the use of HA dermal fillers, as informed by high-quality, low-risk-of-bias studies.

METHODS

This review follows the Cochrane review standards for clinical systematic reviews. This systematic review analyzed 48 high level of evidence studies on the use of hyaluronic acid (HA) dermal fillers in non-surgical facial aesthetics and the adverse events that occurred.The inclusion criteria were randomized control studies on HA dermal fillers and their complications. Excluded were case reports, case series, observational studies, and other non-randomized research due to their inability to provide generalized conclusions and their inherent publication bias.

RESULTS

Adverse events were classified into three categories: expected reactions, product or technique-related adverse events, and severe adverse events. Most adverse events were short-lived injection site reactions, which resolved spontaneously. Specific HA fillers and injection techniques influenced the occurrence of adverse events, which generally resolved within weeks without treatment. Severe adverse events were rare, persisting for months and requiring active medical intervention.

DISCUSSION

This classification system can enhance understanding, prevention, and treatment of HA filler complications, and support patient education. The common complications were injection site reactions, with persistent symptoms treated with topical steroids, NSAIDs, or hyaluronidase. Severe complications included severe edema, angioedema and others, often necessitating specific treatments.

CONCLUSION

HA dermal fillers are generally safe and effective, with most adverse events being transient and mild to moderate in severity. Severe adverse events, although rare, do occur and are generally non-treatment related. Informed consent, patient education, and professional training are crucial for safe and successful outcomes. 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 .

Long-Term Efficacy and Tolerability of a Medium G' HA Filler with Tri-Hyal Technology on the Rejuvenation of the Mobile Facial Zone

Purpose

Injectable hyaluronic acid-based fillers are commonly used for the correction of skin contour irregularities and to smooth skin depressions formed by volume loss during the aging process. These fillers are particularly efficient to restore perioral skin depressions/wrinkles or to correct topographical anomalies. The European directives require a continuous evaluation of the performance of these medical devices, particularly for CE marked products.

Methods

An 18-month prospective randomized single-blind study for the efficacy and safety of ART FILLER Universal (AFU) was performed on the lips, the nasolabial folds, and the marionettes lines. The evaluations were performed on 153 subjects enrolled in this study. The efficacy, the longevity, and the safety were evaluated for the injected areas via area specific clinical scoring after a single injection with the filler and with no re-touch.

Results

We showed here that filler injection induced potent improvements of volume restoration after a single injection on all the treated areas. These beneficial properties of the filler were significant 3 weeks after injection and during the whole study period. Moreover, injections of the filler were well tolerated by the subjects. The recorded adverse events are routinely seen with HA fillers for face volume corrections, and most of these local reactions resolved within 14 days.

Conclusion

AFU was well tolerated and showed a continuous efficacy for at least 18 months, in exploratory analyses.

Effect of Stromal Vascular Fraction on Sustained Volume Retention of Five Different Hyaluronic Acid Fillers

BACKGROUND

The technology of manufacturing hyaluronic acid (HA) fillers is evolving to increase their safety and durability. This study aimed to compare the volume maintenance effect of stromal vascular fraction (SVF) on different types of HA fillers.

METHODS

In this controlled experiment, HA fillers mixed with SVF were injected into the right upper back and HA fillers alone were injected into the left upper back of each mouse. A total of 35 mice were separated into five groups according to the type of commercially used HA filler: Juvederm Voluma XC, Restylane Lyft, Restylane Skinboosters Vital, Giselle Ligne Signature 2, and Giselle Ligne Universal. Nodule size inspection was performed on post-injection days 0, 3, and 56. Ultrasonography for maximal two-dimensional area of filler nodule measurement and histology were performed on the last day of the inspection.

RESULTS

While most of the groups showed a volume reduction of over 50% on day 56, regardless of SVF administration, significant volume maintenance was observed when Giselle Ligne Signature 2 was injected with SVF. Ultrasonographic measurement of two-dimensional filler nodule size showed no significant difference regarding filler types and SVF injection. When compared with the histological results of other fillers mixed with SVF, Giselle Ligne Signature 2 showed marked increase in cell survival and extracellular matrix components in HA particles.

CONCLUSION

SVF showed different efficacies in terms of volume maintenance and cell survival for various HA filler types. The SVF mixture in selective HA filler injections may improve maintenance in clinical settings.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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.