Efficacy and Safety of Cross-Linked Carboxymethylcellulose Filler for Rejuvenation of the Lower Face: A 6-Month Prospective Open-Label Study.

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.

Materials And 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.

Conclusion: 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.