A new study, published in Plastic and Reconstructive Surgery, the official journal of the American Society of Plastic Surgeons (ASPS), has shown that initial and follow-up three-dimensional digital facial scans provide new insights into how hyaluronic acid (HA) fillers restore facial volume.
The study combines objective measurements of volumetric effects with patient satisfaction and other subjective outcomes to better understand both the immediate and long-term changes after HA filler injections, explained senior author Ivona Percec, MD, PhD, of the University of Pennsylvania.
Hyaluronic acid-based fillers are the most popular choice among patients seeking facial rejuvenation, wrinkle reduction, and restoration of age-related volume loss. In 2024, more than 5.3 million such procedures were performed, according to ASPS.
Percec and colleagues evaluated both objective and subjective outcomes of HA filler injections. They used the advanced Vectra M3 3D imaging system to measure immediate and long-term volumetric changes, and the FACE-Q questionnaire to assess facial appearance and quality of life from the patients’ perspective.
The study included 101 women aged 40–65 who underwent HA filler treatments for facial rejuvenation. Three different filler formulations were used in various facial regions. Scans were performed before and immediately after the procedure, as well as at 2–12 weeks, to assess volumetric effects across eight facial areas.
According to tissue displacement factor (TDF), immediately after injection, facial volume increased by 56% to 125%, then decreased as swelling and inflammation subsided. By two weeks, effective volume (EV) was about 90% in the mid- and lower face, and 70% in the lips. At 12 weeks, volume retention averaged about 66% across the face: 79% in the midface (including cheeks), 63% in the upper perioral region (including marionette lines between the nose and lips), and 37% in the lips.
The FACE-Q survey showed significant improvements in subjective outcomes: beyond favorable assessments of overall facial appearance and individual areas, patients reported improved psychological and social well-being. Factors such as age, smoking, and body mass index influenced volume retention.
Differences among facial regions were linked to greater volume loss in areas with high muscle activity, especially the lips, as well as to the physical properties of the finer filler used in those regions. The FACE-Q results confirm that HA fillers can provide patient satisfaction for at least 12 weeks after treatment.
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