title: Safety and efficacy of nonanimal stabilized hyaluronic acid for improvement of mouth corners.
abstract: BACKGROUND
  Esthetic concern with downturned mouth corners ("mouth frown") is increasing in the aging baby-boomer generation. A new technique to offer structural support using the recently approved filler nonanimal stabilized hyaluronic acid (NASHA; Restylane, Q-med Inc., Uppsala, Sweden) is described.
  
  
  METHODS
  Fifteen women with prominent downturned mouth corners met the inclusion criteria for the study. All were photographed before and at 1 week, 3 months, 4.5 months, and 6 months after treatment using a standardized clinical photographic system. NASHA was injected using a standardized technique with nerve block anesthesia to ensure patient comfort.
  
  
  RESULTS
  All 15 women noted swelling, redness, and some local discomfort for several days after the injection. All noted an improvement in the downward angulation of their mouth corners at the first post-treatment visit, with at least partial improvement maintained through the 6-month post-treatment follow-up visit.
  
  
  CONCLUSIONS
  NASHA injection to support the age-related downturn of lateral lip corners was effective, safe, and well tolerated in a small prospective study of middle-aged female subjects. Esthetic satisfaction was greatest in the first 3 months post-treatment, but 40% of subjects still noted improvement at the 6-month follow-up visit.
authors.affiliation: Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia. drjean@carruthers.net
authors.forename: Jean
authors.initials: J
authors.lastname: Carruthers
authors.forename: Arnold W
authors.initials: AW
authors.lastname: Klein
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
authors.forename: Richard G
authors.initials: RG
authors.lastname: Glogau
authors.forename: Douglas
authors.initials: D
authors.lastname: Canfield
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D004954:Esthetics; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D007271:Injections, Intradermal; D008046:Lip; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D006820:Hyaluronic Acid; C445361:Restylane