Aesthetic Improvement, Facial Harmony, and Patient Satisfaction after Lower Face Treatment with a Hyaluronic Acid...

The authors sought to evaluate a flexible, hyaluronic acid (HA) filler, Restylane® Defyne™ (HA_DEF) (Galderma), for combined treatment of chin, nasolabial folds (NLFs), and marionette lines (MLs), in a predefined stepwise order, comparing Down-up (ie, chin first) versus Top-down (NLFs and MLs first) treatment approaches. This postmarketing study complements prior pivotal investigations that demonstrated the safety and effectiveness of HA_DEF treatments of the lower face, by providing a standardized treatment algorithm for combining several treatment areas in the lower face.

HA_DEF was injected at Day 1 in the first treatment area and at Week 3 in the second area (randomized to either Down-up or Top-down order), with optional touch-up (any area) at Week 6. Assessments included Global Aesthetic Improvement Scale (GAIS), skin firmness, facial harmony, patient satisfaction, and safety until Week 9.

Both approaches achieved similar, favorable results at Week 9, with 100% of patients in both groups (Down-up, n=31; Top-down, n=29) demonstrating aesthetic improvement on the GAIS, improved skin firmness and facial harmony, and natural-looking results. Of patients seeking aesthetic improvement of the submental area, 95% in the Top-down group and 100% in the Down-up achieved improvement. Patient-reported endpoints supported these results, with high satisfaction throughout the study. HA_DEF was well tolerated throughout the study.

The results should be considered indicative rather than definitive given the post-marketing design of the study.

Both stepwise approaches may be used for administering HA_DEF when treating the combined areas of chin, NLFs, and MLs.