Background: Nasolabial folds (NLFs) constitute a pivotal aspect of facial aesthetics and are the primary focal points in facial rejuvenation procedures. Collagen-stimulating fillers have gained popularity due to their long-lasting effects and biocomp...
Background: Nasolabial folds (NLFs) constitute a pivotal aspect of facial aesthetics and are the primary focal points in facial rejuvenation procedures. Collagen-stimulating fillers have gained popularity due to their long-lasting effects and biocompatibility.
Objective: This study aimed to comprehensively evaluate the therapeutic efficacy and safety profiles of collagen- stimulating fillers for NLF correction.
Methods: A thorough search of the databases including PubMed, Embase, and Cochrane was performed. Randomized controlled trials published between 2000 and 2023 on the treatment outcomes of collagen-stimulating fillers for NLFs were included. A systematic review and meta-analysis were conducted using the Wrinkle Severity Rating Scale (WSRS), Global Aesthetic Improvement Scale (GAIS), and adverse events.
Results: Among the 144 pertinent studies, nine met the inclusion criteria, including 299 participants for polycaprolactone (PCL), 291 for poly L-lactic acid (PLLA), and 382 for calcium hydroxylapatite (CaHA). PCL showed significantly higher improvement in GAIS (risk ratio [RR], 3.14; 95% confidence interval [CI], 2.29∼4.30; p<0.001) and WSRS (mean difference, 0.71; 95% CI, 0.36∼1.06; p<0.001) at a 12-month interval compared with hyaluronic acid (HA).
CaHA showed marked 12-month GAIS improvement versus HA (RR, 1.51; 95% CI, 1.21∼1.88; p<0.001). PLLA exhibited superior wrinkle improvement compared with HA at week 24, especially in individuals under 52 years of age. No severe complications occurred.
Conclusion: Collagen-stimulating fillers have the potential to be safe, effective, and long-lasting options for NLF correction. Nevertheless, due to the limited data and heterogeneity among the included studies, cautious interpretation is required. Further high-quality clinical trials are required to validate these findings.