Efficacy and Safety of Hyaluronic Acid Lip Fillers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

Despite the growing demand for hyaluronic acid (HA) lip fillers, there is a paucity of robust, quantitative data across high-powered studies. This systematic review and meta-analysis aims to assess the efficacy and safety of HA lip fillers as reported by randomized controlled trials (RCTs). A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines, utilizing PubMed, Embase, and Cochrane, and eligible studies included RCTs with human participants utilizing HA filler for lip augmentation. Meta-analysis evaluated rates of improvement in lip fullness, aesthetic appearance, patient satisfaction, and adverse events. A comprehensive review initially identified 2038 articles. Following screening by title and abstract, full-text review, and risk of bias assessment with the Cochrane risk-of-bias tool for randomized trials, 16 articles were included in the study. Meta-analysis demonstrated that 60% (95% CI, 44%-76%) had improvement in lip fullness, 82% (95% CI, 67%-92%) had improvement in aesthetic appearance, 68% (95% CI, 58%-78%) reported satisfaction, 50% (95% CI, 27%-73%) had adverse events, and 1.1% (95% CI, 1.9-4.0%) had serious adverse events requiring treatment, needing follow-up, or lasting beyond 30 days. The most common adverse events were swelling (78%), firmness (48%), bruising (34%), and tenderness (33%). Across studies with the highest level of evidence, HA filler efficacy and patient satisfaction was moderate to high. Severe adverse reactions were rare, but adverse events were common. Level of Evidence: 1 (Therapeutic).