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A Comparative Study of the Efficacy of Different Tissue Fillers for Nasolabial Fold Correction
Hsi-An Yang1,2, Ta-Hsien Chuang3, Wun-Long Jheng4,5
1Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 40447, Taiwan.
Background:
Nasolabial folds (NLFs), the pronounced furrows extending from the base of the nose to the corners of the mouth, tend to deepen and lengthen as a natural consequence of aging. Currently, one of the most prevalent treatments for NLFs involves injectable tissue fillers. Although various types of fillers have been utilized in clinical settings, there exists a paucity of research dedicated to evaluating their comparative efficacy. Therefore, this study aims to conduct a network meta-analysis to compare the effectiveness of different tissue fillers in treating NLFs.
Methods:
Relevant studies were searched on several online databases. Randomized clinical trials (RCTs) evaluating the efficacy of different tissue fillers for NLF correction were included in the study.
Results:
A total of 20 RCTs were included in the network meta-analysis. Our findings revealed that calcium hydroxylapatite (CaHA), poly-D,L-lactic acid (PDLLA), and hyaluronic acid (HA) demonstrated superior efficacy for NLF amelioration when compared to bovine and human collagen at 6-9 months post-treatment. Notably, CaHA exhibited greater effectiveness than HA; however, no significant difference was observed when compared to PDLLA. Furthermore, the differences among monophasic HA, biphasic small-particle HA, and biphasic large-particle HA were not statistically significant.
Conclusion:
In terms of the effectiveness of tissue fillers for the amelioration of NLFs, CaHA achieved better efficacy compared to HA and collagen at 6-9 months post-treatment. No significant difference was observed between monophasic HA and biphasic HA. However, additional reviews of rigorous RCTs are required for further verification.
Level Of Evidence I:
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 .
