A Hybrid Gel of Hyaluronic Acid and Poly-L-Lactic Acid for Nasolabial Folds by Ligament-targeted Injection

Nasolabial folds (NLFs) significantly impact facial aesthetics. A novel filler combining cross-linked sodium hyaluronate with poly-L-lactic acid-b-polyethylene glycol microspheres (PLLA-b-PEG/HA) has shown potential. This study evaluated the efficacy and safety of the PLLA-b-PEG/HA filler for NLF correction with an innovative ligament-targeted injection technique.

This retrospective study was reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Thirteen participants presenting with mild to severe bilateral NLFs (WSRS scores 2-4), were examined between December 2022 and February 2023. Treatment involved injections of PLLA-b-PEG/HA at the temporal, preauricular, zygomatic, and mandibular ligaments. Efficacy was assessed via the WSRS, Global Aesthetic Improvement Scale, FACE-Q satisfaction with cheeks scale, and participants' satisfaction during a 12-month follow-up period.

At the 12 months, a statistically significant improvement was observed in the mean WSRS score, which decreased from 3.00 ± 0.71 to 1.85 ± 0.90 (P < 0.05), with a response rate of 84.62%. The improvement was sustained through the 12-month period. Significant enhancements were also noted in both the FACE-Q and Global Aesthetic Improvement Scale scores at each posttreatment follow-up visit, with participants reporting high levels of satisfaction. The PLLA-b-PEG/HA filler demonstrated an acceptable safety profile, with only 1 case of transient mild erythema and edema reported.

These preliminary findings suggest that the PLLA-b-PEG/HA filler, combined with a ligament-targeted injection technique, shows promising efficacy and a favorable safety profile for NLF correction over 12 months.