title: Efficacy and Safety of Cross-Linked Carboxymethylcellulose Filler for Rejuvenation of the Lower Face: A 6-Month Prospective Open-Label Study.
abstract: BACKGROUND
  Cross-linked carboxymethylcellulose (CMC) filler is a biosynthetic filler with very low antigenic risk.
  
  
  OBJECTIVE
  To assess the efficacy and safety of CMC filler in the rejuvenation of the lower face.
  
  
  METHODS
  Two hundred eighty-seven procedures were performed in 174 patients: 115 nasolabial folds, 86 marionette lines, 29 bar codes, 14 cheek rhytides, and 43 lip rejuvenations. Results were evaluated at 3 (T1) and 6 months (T2) with photographic evaluation, Global Aesthetic Improvement Scale (GAIS), Modified Fitzpatrick Wrinkle Scale (MFWS) for nasolabial folds, Marionette Lines Grading Scale (MLGS), and Medicis Lip Fullness Scale (LFS).
  
  
  RESULTS
  GAIS was ≥2 in >91.05% of patients both in T1 and T2. MFWS score significantly improved at T1 (86.9% class ≤1, p < .001) and T2 (82.6% class ≤1, p < .001); in all patients in T1 and T2, median amelioration of MLGS was 2 ± 1 and there was a significant amelioration of at least 1 grade in LSF in both upper and lower lips.
  
  
  CONCLUSIONS
  The use of CMC filler resulted in a significant and satisfactory amelioration of lower face aging signs with very low incidence of adverse events. Therefore, it should be considered a valid alternative to cross-linked hyaluronic acid fillers.
authors.affiliation: *Superior Post Graduate School of Aesthetic Medicine of University La Sapienza of Rome, Private Practice, Padua, Italy; †Gastroenterology, Department of Surgery Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy; ‡Burn Unit and Plastic Surgery, University of Padua Medical School, Padua, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: DʼAloiso
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
authors.forename: Bruno
authors.initials: B
authors.lastname: Azzena
mesh_terms: D000328:Adult; D000368:Aged; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage* / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects; D000067548:Dermal Fillers / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D060052:Nasolabial Fold; D017060:Patient Satisfaction; D011446:Prospective Studies; D012060:Rejuvenation; D015595:Skin Aging / Q000187:drug effects*
chemical_list: D000067548:Dermal Fillers; D002266:Carboxymethylcellulose Sodium