Kabakci Ayse Gul, Eren Dilek, Bozkir Dursun Murat, Cengizler Çağlar, Esen Eda Esra, Türközer Yaşam, Bozkir Memduha Gülhal
Department of Anatomy, Cukurova University, Adana, Turkey.
Dr Dilek Eren Medical Aesthetic Clinic, Adana, Turkey.
Medicine (Baltimore). 2025 May 9;104(19):e42390. doi: 10.1097/MD.0000000000042390.
This study is among the first to systematically evaluate the indirect anatomical effects of hyaluronic acid injections on the glabellar and nasolabial regions. It focuses on changes in wrinkle severity and anatomical parameters to enhance safety and efficacy. In this study, we analyzed pre- and post-treatment photographs of 31 women with a mean age of 45.97 ± 7.10, who received hyaluronic acid treatment. The study was designed retrospectively. Photographs taken before the procedure and one month after treatment were obtained from the clinical archive. Digital anatomical measurements were performed on these images. The anatomical measurements focused on the glabella (including facial convexity, total facial convexity, and facial concavity) and the nasolabial regions (including nasolabial and nasolabial fold angles on both the right and left sides). Wrinkle Severity Rating Scale (WSRS) evaluations were also conducted for both the glabella and nasolabial folds. Evaluations were performed by analyzing photographs taken before, 4 weeks after, and 12 weeks after hyaluronic acid filler application. In the glabellar region, hyaluronic acid injections into the temporal and zygomatic areas significantly reduced wrinkles, especially 12 weeks post-treatment (P = .004), indicating an indirect improvement in glabellar wrinkles. A positive correlation between age and wrinkle improvement was found (r = 0.601, P = .000), suggesting more pronounced effects in older individuals. In the nasolabial region, significant reductions were observed in both the right (P < .001) and left (P < .001) nasolabial folds post-treatment, with age also correlating with improvement (right: r = 0.693, P = .000; left: r = 0.496, P = .005). The S300 and S500 formulations reduced wrinkles, with the S500 showing greater efficacy than the S300. The findings of our study suggest that hyaluronic acid fillers can indirectly reduce the depth of nasolabial folds, and this effect can be achieved particularly when applied using techniques that are suitable for anatomical and vascular structures. This approach may be considered a viable alternative in aesthetic procedures, as it has the potential to enhance treatment safety by reducing the risk of complications associated with direct interventions.
本研究是首批系统评估透明质酸注射对眉间和鼻唇沟区域间接解剖学影响的研究之一。它聚焦于皱纹严重程度和解剖学参数的变化，以提高安全性和有效性。在本研究中，我们分析了31名平均年龄为45.97±7.10岁接受透明质酸治疗的女性治疗前和治疗后的照片。该研究为回顾性设计。从临床档案中获取手术前和治疗后1个月拍摄的照片。对这些图像进行数字解剖测量。解剖测量集中在眉间（包括面部凸度、面部总凸度和面部凹度）和鼻唇沟区域（包括左右两侧的鼻唇沟和鼻唇沟角度）。还对眉间和鼻唇沟进行了皱纹严重程度评分量表（WSRS）评估。通过分析透明质酸填充剂应用前、应用后4周和12周拍摄的照片进行评估。在眉间区域，颞部和颧部注射透明质酸可显著减少皱纹，尤其是治疗后12周（P = 0.004），表明眉间皱纹有间接改善。发现年龄与皱纹改善之间存在正相关（r = 0.601，P = 0.000），表明在年龄较大的个体中效果更明显。在鼻唇沟区域，治疗后右侧（P < 0.001）和左侧（P < 0.001）鼻唇沟均显著减少，年龄也与改善相关（右侧：r = 0.693，P = 0.000；左侧：r = 0.496，P = 0.005）。S300和S500配方可减少皱纹，S500的疗效优于S300。我们的研究结果表明，透明质酸填充剂可间接减少鼻唇沟深度，特别是在采用适合解剖和血管结构的技术进行应用时可实现这种效果。这种方法在美容手术中可被视为一种可行的替代方案，因为它有可能通过降低与直接干预相关的并发症风险来提高治疗安全性。
