title: Carbon dioxide therapy and hyaluronic acid for cosmetic correction of the nasolabial folds.
abstract: BACKGROUND
  The main application of hyaluronic acid filling, in esthetic medicine, is the augmentation of soft tissues. The carbon dioxide therapy, instead, improves quality and elasticity of the dermis and increases the oxygen release to the tissue through an enhancing of the Bohr's effect. The aim of the study was to compare the efficacy, tolerability, and effect duration of hyaluronic acid fillers and the use of carbon dioxide therapy plus hyaluronic acid in the cosmetic correction of nasolabial folds.
  
  
  METHODS
  Forty healthy female patients received a blinded and randomized treatment on nasolabial folds (hyaluronic acid in group A and hyaluronic acid plus subcutaneous injections of carbon dioxide in group B) for cosmetic correction of the nasolabial folds. The results were evaluated by two blinded plastic surgeons after the implant (1 week, 4 and 6 months) using a 1-5 graduated scale (GAIS), and at the same time, each patient was asked to express her opinion about the cosmetic result.
  
  
  RESULTS
  Any long-term adverse reaction was reported. The blinded evaluation at 4 and 6 months from the implant shows in all patients a maintenance of a good cosmetic result higher for the side treated with carbon dioxide therapy plus hyaluronic acid.
  
  
  CONCLUSIONS
  At the control visit, 6 months after the treatment, the patients treated with hyaluronic acid plus carbon dioxide therapy maintain a satisfactory esthetic result while the nasolabial fold treated only with hyaluronic acid shows, in almost all patients, a come back to pretreatment appearance.
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nisi
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cuomo
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Brandi
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Grimaldi
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sisti
authors.affiliation: General and Specialistic Surgery Department, Plastic Surgery Division, "S. Maria alle Scotte" Polyclinic, University of Siena, Siena, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: D'Aniello
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003357:Cosmetic Techniques; D000067548:Dermal Fillers / Q000008:administration & dosage*; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D008875:Middle Aged; D060052:Nasolabial Fold; D016037:Single-Blind Method; D015595:Skin Aging / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000067548:Dermal Fillers; D002245:Carbon Dioxide; D006820:Hyaluronic Acid
keywords: carbon dioxide therapy; fillers; hyaluronic acid; nasolabial folds