A Large Prospective Volumetric and Patient-Reported Outcome Analysis Of Hyaluronic Acid Fillers to the Face.

Background: Hyaluronic acid (HA) facial fillers are a non-surgical treatment for age-related changes. Literature on long-term volumetric results and patient-reported outcomes (PROs) is limited. This prospective study aims to precisely define and measure objective tissue metrics and PROs of HA fillers in different facial regions over 12 weeks.

Methods: Females aged 40 to 65 received injections in facial regions using HA fillers: Restylane-L® in nasolabial folds and marionette lines, Restylane-L Lyft® in the malars, and Restylane Silk® in the lip border. Patients completed FACE-Q® questionnaires, were photographed with 3D Vectra® M3 Imaging Software pre-injection, immediately post-injection, and at 2-, 4-, and 12-weeks post-injection. Volumes were analyzed from eight regions: left, right malars and extended midface (MEM), upper perioral (UP), lower perioral and jawline (LPJ), and lips. Tissue displacement factor (TDF) and effective volume (EV) were calculated. Statistical analyses included Mann Whitney U tests and risk-adjusted linear regression.

Results: 101 women participated. Restylane-L Lyft® had the highest TDF, 1.25, followed by Restylane-L®, 1.14, and Restylane Silk®, 0.56. EV for Restylane-L Lyft® was highest, 89.8%, followed by Restylane-L®, 89.7%, and Restylane Silk®, 70%. Volume maintenance was 65.5% (whole face), 79.2% (MEM), 62.7% (UP), and 37.2% (lips) over 12 weeks. PROs demonstrated improvements in facial appearance, treated regions, psychological and social function.

Conclusions: We define the novel tissue metrics, TDF and EV, relative to HA treatments, with greatest volume maintenance in the midface and greatest loss around the mimetic areas throughout 12 weeks. Significantly improved PROs were observed for patients undergoing large volume HA filler injections.