Next-Generation Hyaluronic Acid Fillers for Nasolabial Fold Treatment
Advances in hyaluronic acid (HA) filler technology are refining lower face rejuvenation by improving injection characteristics, predictability, and patient satisfaction, according to Michael H. Gold, MD, during his Music City SCALE 2026 session, “Hands-On Workshop: Optimizing Outcomes in Lower Face Rejuvenation with Next-Gen Hyaluronic Acid Fillers.”
The session highlighted findings from a multicenter, randomized, split-face clinical trial comparing Princess Filler Lidocaine (PFL) with Juvéderm Ultra XC (JUXC) for nasolabial fold (NLF) treatment. The study enrolled 270 patients with moderate-to-severe folds, using a blinded, non-inferiority design to evaluate clinical outcomes.
Both fillers demonstrated meaningful improvement in NLF severity, with the primary endpoint defined as at least a 1-point improvement on the NLF Severity Rating Scale at 24 weeks. Secondary outcomes included investigator and patient assessments, as well as validated patient-reported measures. At 48 weeks, Global Aesthetic Improvement Scale responder rates reached 84.9%, with high patient satisfaction. At 3 months, “90% of patients were pleased with their results,” supporting sustained clinical benefit.
Injection technique was standardized using retrograde linear threading and fanning, emphasizing consistent placement for optimal results. However, the presentation underscored that outcomes depend not only on technique but also on filler rheology.
Particle size distribution and gel homogeneity were identified as critical determinants of performance. Uniform particle size enables smoother injection and more predictable tissue integration, while a consistent gel matrix supports even flow and reliable outcomes. Dr Gold emphasized that “uniform particle sizes enable smooth injection and predictable tissue integration,” highlighting the role of manufacturing precision.
Differences in crosslinking and HA concentration also influence clinical behavior. The studied filler featured high molecular weight HA with minimal crosslinking and a narrower particle size distribution, contributing to ease of injection and consistency in results.
Safety considerations were integrated into the discussion, reinforcing the concept that “safety shapes outcomes.” Consistent product characteristics and proper technique are essential to minimizing complications and achieving natural results.
For more meeting coverage, visit the Music City SCALE newsroom.
Reference
Gold MH. Hands-on workshop: optimizing outcomes in lower face rejuvenation with next-gen hyaluronic acid fillers. Presented at: Music City SCALE Symposium; May 13–17, 2026; Nashville, TN.
