Biopolymers in Facial Aesthetics: Gel-Based Applications, Safety, Effectiveness, and Future Prospects—A Systematic Review of the Literature

Abstract

Biopolymer-based dermal fillers have gained attention in facial aesthetics due to their biocompatibility, gel-forming properties, and capacity to stimulate tissue regeneration. However, evidence regarding their clinical performance remains scattered and inconsistent. This systematic review evaluates the current scientific literature on the effectiveness and safety of injectable biopolymers used in facial aesthetic procedures. A systematic search was conducted in PubMed, MEDLINE, and Embase databases for studies published between 2016 and 2024. Only human studies in English assessing clinical efficacy, safety, adverse events, and patient satisfaction were included. Of the 280 articles initially identified, 9 met the inclusion criteria. The selected studies showed improvements in facial volume and wrinkle reduction with gel-based biopolymers such as poly-L-lactic acid (PLLA), polycaprolactone (PCL), and polymethylmethacrylate (PMMA). Most studies reported high patient satisfaction and a low incidence of serious adverse effects. However, methodological heterogeneity and limited long-term data reduced the strength of the evidence. While injectable biopolymers appear to be effective and generally safe, current evidence is limited and variable. Further multicenter randomized trials with standardized protocols and longer follow-up periods are needed. Clinicians should apply these materials with caution, ensuring individualized treatment planning and careful risk assessment.