A Comparative Study of the Efficacy of Different Tissue Fillers for Nasolabial Fold Correction

Hsi-An Yang; Ta-Hsien Chuang; Wun-Long Jheng

doi:10.1007/s00266-025-05423-5

A Comparative Study of the Efficacy of Different Tissue Fillers for Nasolabial Fold Correction

Aesthetic Plast Surg. 2025 Nov 7. doi: 10.1007/s00266-025-05423-5. Online ahead of print.

Authors

Hsi-An Yang^{1

2}, Ta-Hsien Chuang³, Wun-Long Jheng^{4

5}

Affiliations

¹ Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 40447, Taiwan.
² Department of Education, Chang Gung Memorial Hospital, Taoyuan, 333423, Taiwan.
³ School of Pharmacy, China Medical University, Taichung, 406040, Taiwan. thchuang@mail.cmu.edu.tw.
⁴ Department of Medical Research, Longwood Center for Healthcare Engineering, Boston, MA, USA. school111360@gmail.com.
⁵ Cancer Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan. school111360@gmail.com.

PMID: 41204009
DOI: 10.1007/s00266-025-05423-5

Abstract

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 .

Keywords: Efficacy; Nasolabial fold; Network meta-analysis; Tissue filler.