Study: PLLA Outlasts HA for Nasolabial Fold Correction at 120 Weeks
Key Takeaways
- PLLA and HA fillers produced similar nasolabial fold correction through 12 weeks in a randomized multicenter trial.
- By 120 weeks, effective correction rates were 55.56% with PLLA versus 25.00% with HA (P < 0.001).
- Attrition was substantial: 135 of the original 208 randomized participants were included in the 120-week analysis, and the extension was observational.
Poly-L-lactic acid (PLLA) and hyaluronic acid (HA) fillers followed markedly different efficacy trajectories over more than 2 years after treatment for moderate-to-severe nasolabial folds (NLFs), according to a multicenter randomized trial published online in The Journal of Craniofacial Surgery.
Investigators enrolled adults aged 18 to younger than 65 years with bilateral grade 3 or 4 NLFs on the Wrinkle Severity Rating Scale (WSRS) at 6 centers in China. The parent trial randomized 208 participants to PLLA (n = 106) or HA (n = 102) and followed them for 52 weeks after their final injection. An observational extension continued follow-up through week 120, with 135 participants included in the long-term analysis.
PLLA and HA Efficacy Curves Diverge Over Time
Early outcomes were comparable. WSRS effective correction rates at week 4 were 89.80% with PLLA and 92.78% with HA (P = 0.461), while week 12 rates were 90.00% and 88.12%, respectively (P = 0.670). The treatment curves subsequently separated in favor of PLLA at weeks 24, 36, and 52.
At week 120, 55.56% of participants receiving PLLA (35/63) maintained effective WSRS correction compared with 25.00% receiving HA (18/72; P < 0.001).
Participant-rated Global Aesthetic Improvement Scale (GAIS) improvement was numerically higher with PLLA than HA (73.02% vs 56.94%; P = 0.108). Investigator-rated GAIS improvement favored PLLA (80.95% vs 63.89%; P = 0.024). No late device-related safety events were observed.
Interpretation of the long-term findings is limited by attrition and the observational nature of the extension.
“PLLA and HA showed similar short-term efficacy through 12 weeks, whereas PLLA provided superior long-term performance through 120 weeks,” the authors wrote. “These findings support PLLA as a durable biostimulatory option when sustained correction is prioritized, while also underscoring that long-term extension data should be interpreted in light of attrition and observational follow-up.”
Source
Liu Y, et al. Journal of Craniofacial Surgery. 2026. Doi:10.1097/SCS.0000000000013290