Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Non-Surgical Aesthetic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

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).

Methods

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.

Results

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.

Conclusions

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 www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Fagien S, Monheit G, Jones D et al (2017) Hyaluronic acid gel with (HARRL) and without lidocaine (HAJU) for the treatment of moderate-to-severe nasolabial folds: a randomized, evaluator-blinded, phase III study. Dermatol Surg. https://doi.org/10.1097/dss.0000000000001368

    Article  PubMed  Google Scholar 

  2. Levy PM, De Boulle K, Raspaldo H (2009) Comparison of injection comfort of a new category of cohesive hyaluronic acid filler with preincorporated lidocaine and a hyaluronic acid filler alone. Dermatol Surg 35(Suppl 1):332–336 (discussion 337)

    Article  PubMed  CAS  Google Scholar 

  3. Matarasso SL, Carruthers JD, Jewell ML et al (2006) Consensus recommendations for soft-tissue augmentation with nonanimal stabilized hyaluronic acid (Restylane). Plast Reconstr Surg 117(3 Suppl):3S–34S (discussion 35S–43S)

    Article  PubMed  Google Scholar 

  4. Suh JH, Oh CT, Im SI et al (2017) A multicenter, randomized, double-blind clinical study to evaluate the efficacy and safety of a new monophasic hyaluronic acid filler with lidocaine 0.3% in the correction of nasolabial fold. J Cosmet Dermatol 16(3):327–332

    Article  PubMed  Google Scholar 

  5. Lee JH, Kim SH, Park ES (2017) The efficacy and safety of HA IDF Plus (with lidocaine) versus HA IDF (without lidocaine) in nasolabial folds injection: a randomized, multicenter, double-blind, split-face study. Aesthet Plast Surg 41(2):422–428

    Article  Google Scholar 

  6. Kuhne U, Esmann J, von Heimburg D et al (2016) Safety and performance of cohesive polydensified matrix hyaluronic acid fillers with lidocaine in the clinical setting—an open-label, multicenter study. Clin Cosmet Invest Dermatol 9:373–381

    Article  Google Scholar 

  7. Bulam H, Sezgin B, Tuncer S et al (2015) A severe acute hypersensitivity reaction after a hyaluronic acid with lidocaine filler injection to the lip. Arch Plast Surg 42(2):245–247

    Article  PubMed  PubMed Central  Google Scholar 

  8. Sharma P, Sharma S (2011) Comparative study of a new dermal filler Uma Jeunesse® and Juvederm®. J Cosmet Dermatol 10(2):118–125

    Article  PubMed  Google Scholar 

  9. Moher D, Shamseer L, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1

    Article  PubMed  PubMed Central  Google Scholar 

  10. Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12

    Article  PubMed  CAS  Google Scholar 

  11. Banares R, Albillos A, Rincon D et al (2002) Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology 35(3):609–615

    Article  PubMed  Google Scholar 

  12. Royo de la Torre J, Moreno-Moraga J, Isarria MJ et al (2013) The evaluation of hyaluronic acid, with and without lidocaine, in the filling of nasolabial folds as measured by ultrastructural changes and pain management. J Drugs Dermatol 12(3):e46–e52

    PubMed  Google Scholar 

  13. Weiss R, Bank D, Brandt F (2010) Randomized, double-blind, split-face study of small-gel-particle hyaluronic acid with and without lidocaine during correction of nasolabial folds. Dermatol Surg 36(s1):750–759

    Article  CAS  Google Scholar 

  14. Raspaldo H, De Boulle K, Levy PM (2010) Longevity of effects of hyaluronic acid plus lidocaine facial filler. J Cosmet Dermatol 9(1):11–15

    Article  PubMed  Google Scholar 

  15. Monheit GD, Campbell RM, Neugent H et al (2010) Reduced pain with use of proprietary hyaluronic acid with lidocaine for correction of nasolabial folds: a patient-blinded, prospective, randomized controlled trial. Dermatol Surg 36(1):94–101

    Article  PubMed  Google Scholar 

  16. Monheit GD, Baumann LS, Gold MH et al (2010) Novel hyaluronic acid dermal filler: dermal gel extra physical properties and clinical outcomes. Dermatol Surg 36(Suppl 3):1833–1841

    Article  PubMed  CAS  Google Scholar 

  17. Lupo MP, Swetman G, Waller W (2010) The effect of lidocaine when mixed with large gel particle hyaluronic acid filler tolerability and longevity: a six-month trial. J Drugs Dermatol 9(9):1097–1100

    PubMed  Google Scholar 

  18. Hedén P, Fagrell D, Jernbeck J et al (2010) Injection of stabilized hyaluronic acid-based gel of non-animal origin for the correction of nasolabial folds: comparison with and without lidocaine. Dermatol Surg 36(s1):775–781

    Article  CAS  Google Scholar 

  19. Brandt F, Bank D, Cross SL et al (2010) A lidocaine-containing formulation of large-gel particle hyaluronic acid alleviates pain. Dermatol Surg 36(Suppl 3):1876–1885

    Article  PubMed  CAS  Google Scholar 

  20. Levy PM, De Boulle K, Raspaldo H (2009) A split-face comparison of a new hyaluronic acid facial filler containing pre-incorporated lidocaine versus a standard hyaluronic acid facial filler in the treatment of naso-labial folds. J Cosmet Laser Ther 11(3):169–173

    Article  PubMed  Google Scholar 

  21. Weinkle SH, Bank DE, Boyd CM et al (2009) A multi-center, double-blind, randomized controlled study of the safety and effectiveness of Juvederm injectable gel with and without lidocaine. J Cosmet Dermatol 8(3):205–210

    Article  PubMed  Google Scholar 

  22. Day DJ, Littler CM, Swift RW et al (2004) The wrinkle severity rating scale: a validation study. Am J Clin Dermatol 5(1):49–52

    Article  PubMed  Google Scholar 

  23. Brandt FS, Cazzaniga A (2008) Hyaluronic acid gel fillers in the management of facial aging. Clin Interv Aging 3(1):153–159

    PubMed  PubMed Central  CAS  Google Scholar 

  24. Choi WJ, Han SW, Kim JE et al (2015) The efficacy and safety of lidocaine-containing hyaluronic acid dermal filler for treatment of nasolabial folds: a multicenter, randomized clinical study. Aesthet Plast Surg 39(6):953–962

    Article  Google Scholar 

  25. Fischer TC, Sattler G, Gauglitz GG (2016) Hyaluron filler containing lidocaine on a CPM basis for lip augmentation: reports from practical experience. Facial Plast Surg 32(3):283–288

    Article  PubMed  CAS  Google Scholar 

  26. Prager W, Micheels P (2015) A prospective, comparative survey to investigate practitioners’ satisfaction with a cohesive, polydensified-matrix®, hyaluronic acid-based filler gel with and without lidocaine for the treatment of facial wrinkles. J Cosmet Dermatol 14(2):124–129

    Article  PubMed  Google Scholar 

  27. Andre P (2004) Evaluation of the safety of a non-animal stabilized hyaluronic acid (NASHA—Q-Medical, Sweden) in European countries: a retrospective study from 1997 to 2001. J Eur Acad Dermatol Venereol 18(4):422–425

    Article  PubMed  CAS  Google Scholar 

  28. Chopra R, Graivier M, Fabi S et al (2018) A multi-center, open-label, prospective study of cannula injection of small-particle hyaluronic acid plus lidocaine (SPHAL) for lip augmentation. J Drugs Dermatol 17(1):10–16

    PubMed  Google Scholar 

Download references

Funding

No funding was received for this article.

Author information

Authors and Affiliations

  1. Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, China

    Chenglong Wang, Minqiang Xin & Jie Luan

  2. Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

    Sisi Luan

  3. Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

    Adriana C. Panayi

  4. Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

    Bobin Mi

Authors
  1. Chenglong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sisi Luan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Adriana C. Panayi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Minqiang Xin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Bobin Mi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jie Luan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jie Luan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, C., Luan, S., Panayi, A.C. et al. Effectiveness and Safety of Hyaluronic Acid Gel with Lidocaine for the Treatment of Nasolabial Folds: A Systematic Review and Meta-analysis. Aesth Plast Surg 42, 1104–1110 (2018). https://doi.org/10.1007/s00266-018-1149-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-018-1149-3

Keywords

Search

Navigation