title: A systematic review of dermal fillers for age-related lines and wrinkles.
abstract: BACKGROUND
  Dermal fillers are gaining popularity for rapid aesthetic improvement. Long-term efficacy and safety have not been well documented. The aim of this systematic review was to assess the safety and efficacy of injectable dermal fillers compared with other facial augmentation techniques for the management of age-related lines and wrinkles.
  
  
  METHODS
  Studies including patients receiving injectable semi-permanent or permanent dermal fillers for age-related lines and wrinkles were included in this review. Efficacy outcomes (including changes in skin thickness and patient satisfaction) and safety outcomes (including mortality, lumps and infections) were examined.
  
  
  RESULTS
  Three randomized control trials and six case series were included. Permanent and semi-permanent dermal fillers improved subjective ratings of appearance and resulted in higher patient satisfaction than temporary fillers. Long-term efficacy appeared good in the few studies that reported it. Short-term safety appeared favourable. Lumps were reported in all but one study but received little follow-up. Long-term safety data were limited.
  
  
  CONCLUSIONS
  The treatment of age-related lines and wrinkles with permanent and semi-permanent dermal fillers is more efficacious compared with temporary fillers in those studies that compared them. Case series evidence suggests that these fillers achieve their objective, which is to decrease the visible effects of age-related changes. These fillers appear at least as safe as temporary fillers in the short term in those studies that compared them. Long-term safety could not be determined.
authors.affiliation: Royal Australasian College of Surgeons, Adelaide, SA, Australia.
authors.forename: Lana P
authors.initials: LP
authors.lastname: Sturm
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Cooter
authors.forename: Keith L
authors.initials: KL
authors.lastname: Mutimer
authors.forename: John C
authors.initials: JC
authors.lastname: Graham
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects / Q000627:therapeutic use*; D003094:Collagen / Q000009:adverse effects / Q000627:therapeutic use; D017886:Durapatite / Q000009:adverse effects / Q000627:therapeutic use; D004983:Ethanolamines / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006820:Hyaluronic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D057748:Mesotherapy / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D011108:Polymers / Q000009:adverse effects / Q000627:therapeutic use*; D012828:Silicones / Q000009:adverse effects / Q000627:therapeutic use; D015595:Skin Aging; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D004983:Ethanolamines; D011108:Polymers; D012828:Silicones; C049816:hylan; D006820:Hyaluronic Acid; D003094:Collagen; D017886:Durapatite; C007369:2-diethylaminoethanol