Hyaluronic Acid Injection Method Based On Facial Retaining Ligament Theory In Treating With Nasolabial Fold

Background:Hyaluronic acid is the most popular dermal filler in the treatment of nasolabial folds.Injection methods vary among physicians.Methods:A randomized,two-center,double-blind,intraindividual trial was designed to compare a new method of injecting ART FILLER? UNIVERSAL using the retaining ligament with the traditional method(linear threading and bolus injection)in moderate to severe nasolabial folds.Forty patients with moderate to severe nasolabial folds were randomized into groups A and B.Group A received injections via the traditional method on the left side and the ligament method on the right side,while group B received the reverse.Clinical efficacy and patient safety were independently assessed by a blinded evaluator,the injector,using the Wrinkle Severity Rating Scale(WSRS),the Global Aesthetic Improvement Scale(GAIS)and the Medicis Midface Volume Scale(MMVS)at 4 weeks(before and after the touchup injection),8 weeks,12 weeks and 24 weeks after the baseline injection.Results:From the perspective of the blinded evaluator,the improvements in WSRS scores from baseline did not differ significantly between the ligament method(0.73±0.61)and the traditional method(0.89±0.61)at week 24(p>0.05).The mean GAIS score at week 24 was 1.41±0.49 for the traditional method and 1.32±0.47 for the ligament method(p>0.05).Conclusions:The efficacy and safety of the ligament method for the management of nasolabial folds are comparable to those of the traditional method in terms of WSRS and GAIS score improvement in the long run.The ligament method is superior to the traditional method as it improves midface deficits with fewer adverse events.