Post-treatment Dermal Thickness after Repeated Autologous Albumin Platelet-rich Fibrin Versus Hyaluronic Acid at the Nasolabial Fold: An Age-adjusted Ultrasound Comparative Study

Abstract

Background: Nasolabial-fold correction can be achieved with hyaluronic acid (HA) fillers or autologous platelet-rich fibrin-based materials, but post-treatment tissue thickness may reflect different structural effects. Aims: To determine whether repeated autologous albumin platelet-rich fibrin treatment is associated with a stronger sonographic dermal-thickness signal than repeated hyaluronic acid treatment at the nasolabial fold after accounting for age. Study Design: Retrospective cross-sectional comparative study. Place and Duration of Study: Cardiomed Jura, Courrendlin, Switzerland. The albumin platelet-rich fibrin cohort received three sessions over approximately one year; ultrasound was performed three months after the third session. The hyaluronic acid cohort had received at least three treatments during the preceding three years, with imaging at least three months after the latest treatment. Methodology: Twenty women were included (10 per group). High-frequency ultrasound assessed post-treatment dermal thickness. Exact Mann-Whitney testing, within-group Spearman correlations, and an exploratory age-adjusted linear model were used. Results: Mean age was 57.1 ± 8.0 years for hyaluronic acid and 52.1 ± 7.0 years for albumin platelet-rich fibrin (P = .22). Mean dermal thickness was 1.34 ± 0.09 versus 2.29 ± 0.21 mm, respectively (difference, 0.95 mm; U = 0; P < .001). Thickness decreased with age in both cohorts. After adjustment, albumin platelet-rich fibrin remained associated with 0.86 mm greater thickness (95% CI, 0.77-0.95; P < .001). Conclusion: Repeated albumin platelet-rich fibrin was associated with a marked age-independent post-treatment dermal-thickness signal compared with repeated hyaluronic acid. This objective signal is compatible with dermal remodelling; however, the absence of pretreatment ultrasound precludes proof of treatment-induced regeneration or neocollagenesis.