Clinical Efficacy Comparison Of Hyaluronic Acid Injection On Different Depths In Correction Of Severe Nasolabial Folds (NLF)

Objective:The efficacy and safety of hyaluronic acid injection at different depths for correction of severe nasolabial folds(NLF)in Chinese were compared among periosteal surface?subcorium injection and both.Methods:In this study,A total of 120 subjects(102 females and 18 males)with 4 scores of nasolabial fold were randomly divided into group A?group B and group C(40 subjects each).In group A,the subjects'bilateral nasolabial folds were filled with hyaluronic acid under the dermis.In group B,the subjects' bilateral nasolabial folds were filled with hyaluronic acid on the periosteal surface.In group C,the subjects'bilateral nasolabial folds were filled with hyaluronic acid both on the periosteal surface and subcorium.Positive and lateral photos and scores of WSRS,GAIS and GICS were recorded before surgery,one month after surgery,three months after surgery,and six months after surgery.Statistical analysis was performed by spss22.0 statistical software,and P<0.05 was statistically significant.To summarize the rules and compare the effectiveness and safety of hyaluronic acid for correction of severe nasolabial folds at three different injection depths.Results:1.According to statistical analysis,at 6 months after the injection,the effective rates of treatment in groups A,B and C were 80.0%,90.0%and 92.5%,respectively,with no statistically significant difference among the three groups(P=0.202>0.05).There was no significant difference in the effective rates of the three groups at 6 months after injection of hyaluronic acid.2.The obvious improvement rate of the group of periosteal surface combined with the subcorium injection(57.50%)was higher than that of the periosteal surface alone(27.50%),and the obvious improvement rate of the subcorium injection group(10.00%)was the lowest.The injection of hyaluronic acid into the periosteal surface combined with the subcorium had the best long-term effect and the most lasting effect.The subjects were more satisfied with the change of their overall impression and the score is higher.Secondly,the injection of the periosteal surface was well,and the injection of the subcorium was the poorest.3.At 1 month after the injection,the Wrinkle Severity Rating Scale,Global Aesthetic Improvement Scale,and General Impression Change Scale were all the highest,with the most obvious improvement and the highest satisfaction of the subjects.With the development of time,the nasolabial folds gradually deepened and the score gradually decreased.4.Among the subjects,common adverse reactions were swelling,scleroma,hyperemia,tenderness and pain.There was no significant difference in the composition and duration of postoperative adverse reactions among the three groups(P>0.05),and there was no significant difference in the incidence of postoperative adverse reactions after injection among the three groups.Conclusions:1.The effect of injecting hyaluronic acid on the periosteal surface combined with subcorium is better than that only on the periosteal surface or subcorium,and it is more obvious and lasting.Multi-level injection can reduce the risk of vascular embolization in subcorium injection.It can also solve the problem of superficial skin wrinkles that cannot be eliminated when injecting on the periosteal surface.Subjects are more satisfied.It is safe and reliable without obvious long-term complications.2.Hyaluronic acid had the best effect at 1 month after the injection,with the most obvious improvement in wrinkles and the highest satisfaction of subjects.The fill effect fades over time.