Aesthetic Plastic Surgery

, Volume 42, Issue 4, pp 1104–1110 | Cite as

Effectiveness and Safety of Hyaluronic Acid Gel with Lidocaine for the Treatment of Nasolabial Folds: A Systematic Review and Meta-analysis

  • Chenglong Wang
  • Sisi Luan
  • Adriana C. Panayi
  • Minqiang Xin
  • Bobin Mi
  • Jie LuanEmail author
Original Article Non-Surgical Aesthetic



Hyaluronic acid (HA) gel is a widely used dermal filler for the correction facial volume loss. The incorporation of lidocaine with HA provides a pain-relieving alternative for individuals considering facial rejuvenation. The aim of this systematic review and meta-analysis is to compare the effectiveness and safety of HA with lidocaine (HAL) with that of HA without lidocaine for the treatment of nasolabial folds (NLFs).


Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials and Web of Science from inception up to January 2018. Randomized controlled trials (RCTs) were selected based on the inclusion criteria. Outcomes included 100-mm Visual Analogue Scale (VAS) score, Wrinkle Severity Rating Scale score and adverse events.


A total of 908 patients from 12 RCTs were included in the meta-analysis. VAS score within 30 min after injection in the HAL group was much lower than that with just HA group (MD = − 28.83, 95% CI − 36.38 to − 21.28). There was no significant difference in effectiveness between the two products 24 months post-injection (MD = 0.13, 95% CI − 0.15 to 0.41). The main adverse events, such as swelling, erythema, bruising, itching and induration, also showed no significant difference.


HAL is more effective for pain relief than HA alone, but both display similar effectiveness and safety for the correction of NLFs.

Level of Evidence II

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


Hyaluronic acid Lidocaine Nasolabial folds Treatment outcome 



No funding was received for this article.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina
  2. 2.Department of Endocrinology and MetabolismShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
  3. 3.Division of Plastic Surgery, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of Orthopaedics, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

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