title: The long-term efficacy and safety of a subcutaneously injected large-particle stabilized hyaluronic acid-based gel of nonanimal origin in esthetic facial contouring.
abstract: BACKGROUND
  Nonanimal stabilized hyaluronic acid (NASHA) offers longer-lasting correction than many other injectable products and is associated with low risk of immunogenic and hypersensitivity reactions. A new large-particle stabilized hyaluronic acid-based gel has been developed to restore facial volume and define facial contours.
  
  
  OBJECTIVE
  This study was conducted to assess the long-term efficacy and safety of a large-particle stabilized hyaluronic acid-based gel in patients seeking facial contouring.
  
  
  METHODS
  Fifty-seven adult patients seeking esthetic cheek or chin augmentation or both received subcutaneous or supraperiosteal injections or both of large-particle stabilized hyaluronic acid-based gel (20 mg/mL). Efficacy was assessed subjectively using the Global Aesthetic Improvement Scale at intervals up to 12 months after treatment.
  
  
  RESULTS
  After treatment, patients and investigators independently considered treatment sites to be at least somewhat improved in 91% and 96% (6 months), 68% and 77% (9 months), and 58% and 52% (12 months) of cases, respectively. Patient- and investigator-assessed treatment response rates (the proportion of patients showing at least moderate improvement) were 72% and 81% (6 months), 42% and 40% (9 months), and 21% and 15% (12 months), respectively. Most commonly reported adverse events were local injection-site reactions, skin induration, and implant mobility.
  
  
  CONCLUSIONS
  This large-particle stabilized hyaluronic acid-based gel is well tolerated and provides relatively long-lasting esthetic correction of the cheeks and chin after subcutaneous or supraperiosteal injection.
authors.affiliation: The DeLorenzi Clinic, Kitchener, Ontario, Canada.
authors.forename: Claudio
authors.initials: C
authors.lastname: DeLorenzi
authors.forename: Michael
authors.initials: M
authors.lastname: Weinberg
authors.forename: Nowell
authors.initials: N
authors.lastname: Solish
authors.forename: Arthur
authors.initials: A
authors.lastname: Swift
mesh_terms: D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002610:Cheek / Q000601:surgery; D002680:Chin / Q000601:surgery; D005145:Face / Q000601:surgery*; D005260:Female; D005782:Gels; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D011446:Prospective Studies; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D055682:Viscoelastic Substances / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D005782:Gels; D055682:Viscoelastic Substances; D006820:Hyaluronic Acid; C445361:Restylane