Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4973-4982
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4973
Clinical effect of botulinum toxin type A combined with autologous fat grafting in patients with nasolabial fold depression
Ru-Jie Wang, Ying Wang, Jin-Fang Wu, Ting-Ting Si
Ru-Jie Wang, Jin-Fang Wu, Ting-Ting Si, Department of Burns and Plastic Surgery, 903rd Hospital of PLA, Hangzhou 310013, Zhejiang Province, China
Ying Wang, Department of Dermatology, Shanghai Fourth People’s Hospital, Tongji University School of Medicine, Shanghai 200434, China
Co-first authors: Ru-Jie Wang and Ying Wang.
Author contributions: Wang RJ and Wang Y contributed equally to this work and are co-first authors; Wang RJ and Wang Y designed the research and wrote the first manuscript; Wang RJ, Wang Y, Wu JF and Si TT contributed to conceiving the research and analyzing data; Wang RJ and Wang Y conducted the analysis and provided guidance for the research; All authors reviewed and approved the final manuscript.
Supported by Medical and Health Science and Technology Project of Hangzhou, No. B20230855; and Hangzhou Science and Technology Plan Development Project, No. 20210133X01.
Institutional review board statement: This study was approved by the Ethic Committee of 903rd Hospital of PLA.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The clinical data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ting-Ting Si, MM, Doctor, Department of Burns and Plastic Surgery, 903rd Hospital of PLA, No. 14 Lingyin Road, Xihu District, Hangzhou 310013, Zhejiang Province, China. sztsmith@163.com
Received: April 30, 2024
Revised: June 5, 2024
Accepted: June 17, 2024
Published online: August 6, 2024
Processing time: 62 Days and 22 Hours
Abstract
BACKGROUND

Nasolabial fold (NLF) depression can affect the facial appearance of patients to some extent and increase their psychological burdens. In recent years, autologous fat grafting (AFG) combined with botulinum toxin A (BTX-A) injection (AFG + BTX-A injection) has been gradually applied in the treatment of patients with NLF depression. Although studies have been conducted on the efficacy and safety of AFG + BTX-A injection in treating NLF depression, the experimental design, observational indicators, and sample enrollment criteria vary remarkably, making it difficult to draw convincing and consistent conclusions. Thus, further relevant research is warranted.

AIM

To assess the esthetic improvement, efficacy, and safety of AFG + BTX-A injections in patients with NLF depression.

METHODS

This study included 60 patients with NLF depression who were treated in our hospital from February 2019 to April 2021. These patients were categorized into control (n = 30) and observation (n = 30) groups. The observation group received AFG + BTX-A injection, whereas the control group underwent AFG only. All patients were evaluated using the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale. The compactness of facial contours, skin evaluation indexes, adverse reactions, and satisfaction of the two groups were evaluated 3 months postoperatively.

RESULTS

The WSRS scores of the observation group at 1, 3, and 6 months postoperatively were lower than those of the control group (P < 0.05). Three months postoperatively, facial fine lines and pores showed obvious improvement and the skin index score was higher in the observation group than in the control group (P < 0.05). The compactness of facial contours was better in the observation group than in the control group (P < 0.05). In addition, no remarkable differences were noted in the incidence of postoperative adverse reactions such as facial stiffness, facial asymmetry, facial bruising, and facial concavity inequality (P > 0.05).

CONCLUSION

AFG + BTX-A injection is a highly safe, cost-effective, effective, and long-lasting treatment for NLF depression with high esthetic value, which should be promoted in the future.

Keywords: Nasolabial fold depression; Botulinum toxin A; Autologous fat grafting; Esthetics; Safety

Core Tip: The nasolabial fold (NLF) is not only the most prominent feature of midface aging but also a challenging treatment area for plastic surgeons. The combination therapy of botulinum toxin A (BTX-A) injection and autologous fat grafting (AFG) is becoming increasingly popular in the treatment of NLF depression. Although this protocol has certain clinical advantages, the conclusions of previous studies are somewhat controversial. This study revealed that AFG + BTX-A injection is a highly safe, economical, effective, and long-lasting treatment for NLF depression with high esthetic value. Further cross-regional, multicenter, and large-sample studies are warranted to obtain more accurate evidence in clinical practice.