Filler Placement

In a recently published article in the Journal of Cosmetic Dermatology (2014;13:91-98), Goodier et al compared low volume deep placement cheek injection and mid to deep dermal nasolabial fold injection for the correction of nasolabial folds with hyaluronic acid (HA) filler. In this split-face study, 3 injection techniques were utilized: (1) deep bolus injection into the mid to lateral cheek, (2) mid to deep dermal injection into the nasolabial fold, or (3) both techniques. Results were assessed in 4 to 6 weeks by a blinded investigator.

Globally, patients and investigators noted no statistical difference using the wrinkle severity score. All 3 techniques showed improvement. Patients preferred injection using both techniques, which was associated with the greatest amount of filler product injected. The authors concluded that injection of a dermal HA filler into either the nasolabial fold or mid to lateral cheek resulted in similar improvement for the correction of the nasolabial folds.

What’s the issue?

Although this study used a single HA agent, it showed that patients’ nasolabial folds improved using both techniques: deep depot placement in the cheeks and mid to deep dermal nasolabial fold injection. It may come as no surprise that patients in this study showed a slight preference for both techniques. Although the trend now is to add volume and not fill, a combination of these techniques may give the best outcomes. What do you use in your practice? A study comparing different HA fillers available or one comparing HA to non-HA products would be interesting. Which agents do you use in your practice for nasolabial fold correction?

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