Skip to main content
Top
Published in: Aesthetic Plastic Surgery 2/2019

01-04-2019 | Ultrasound | Original Article

Randomized Double-Blind Controlled Study on the Safety and Efficacy of a Novel Injectable Cross-linked Hyaluronic Gel for the Correction of Moderate-to-Severe Nasolabial Wrinkles

Authors: Pasquale Fino, Marco Toscani, Francesca Romana Grippaudo, Nicola Giordan, Nicolò Scuderi

Published in: Aesthetic Plastic Surgery | Issue 2/2019

Login to get access

Abstract

Introduction

The current study compares two hyaluronic acid fillers, Ial System Duo and Belotero Basic/Balance, for the treatment of wrinkles.

Materials and Methods

This is a single-center, double-blind randomized controlled study. Inclusion criteria consisted of subjects with bilateral nasolabial wrinkles. Each subject was treated with both products: One was applied on the right side and the other on the left side of the face. The quantity of product injected and any problems or local reactions (erythema, edema, pain or itching) were recorded and reassessed at 3 and 6 months and then monthly until complete absorption of the product. The Wrinkle Severity Rating Scale (WSRS) and the Global Aesthetic Improvement Scale (GAIS) were used for the assessment, as well as an ultrasound measurement of the skin thickness.

Results

Complete data were available for 59 subjects. At 3 and 6 months, both products showed improvement in the WSRS and GAIS score in the areas treated compared to pre-treatment assessments, although no significant differences were observed between them. No resulting significant differences were observed on skin thickness among the two products, which were completely reabsorbed in 285 ± 34 days (Ial System Duo) and 277 ± 34 days (Belotero Basic/Balance; Student’s t test: p = 0.2181). No significant differences were observed with regard to the subject’s satisfaction and adverse events.

Conclusions

The Ial System Duo achieves long-term permanence (more than 9 months confirmed by ultrasound) in correction of moderate and severe wrinkles, similar to Belotero Basic/Balance. Both products showed a high safety profile and a high degree of subject and physician satisfaction.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Rho NK, Chang YY, Chao YY, Furuyama N, Huang PY, Kerscher M, Kim HJ, Park JY, Peng HL, Rummaneethorn P, Rzany B, Sundaram H, Wong CH, Yang Y, Prasetyo AD (2015) Consensus recommendations for optimal augmentation of the asian face with hyaluronic acid and calcium hydroxylapatite fillers. Plast Reconstr Surg 136:940–956CrossRefPubMed Rho NK, Chang YY, Chao YY, Furuyama N, Huang PY, Kerscher M, Kim HJ, Park JY, Peng HL, Rummaneethorn P, Rzany B, Sundaram H, Wong CH, Yang Y, Prasetyo AD (2015) Consensus recommendations for optimal augmentation of the asian face with hyaluronic acid and calcium hydroxylapatite fillers. Plast Reconstr Surg 136:940–956CrossRefPubMed
2.
go back to reference Sundaram H, Liew S, Signorini M, Vieira Braz A, Fagien S, Swift A, De Boulle KL, Raspaldo H, Trindade de Almeida AR, Monheit G (2016) Global aesthetics consensus: hyaluronic acid fillers and botulinum toxin type A-recommendations for combined treatment and optimizing outcomes in diverse patient populations. Plast Reconstr Surg 137:1410–1423CrossRefPubMedPubMedCentral Sundaram H, Liew S, Signorini M, Vieira Braz A, Fagien S, Swift A, De Boulle KL, Raspaldo H, Trindade de Almeida AR, Monheit G (2016) Global aesthetics consensus: hyaluronic acid fillers and botulinum toxin type A-recommendations for combined treatment and optimizing outcomes in diverse patient populations. Plast Reconstr Surg 137:1410–1423CrossRefPubMedPubMedCentral
3.
go back to reference Bass LS (2015) Injectable filler techniques for facial rejuvenation, volumization, and augmentation. Facial Plast Surg Clin North Am 23:479–488CrossRefPubMed Bass LS (2015) Injectable filler techniques for facial rejuvenation, volumization, and augmentation. Facial Plast Surg Clin North Am 23:479–488CrossRefPubMed
6.
go back to reference Prager W, Steinkraus V (2010) A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero® Basic versus Restylane® for correction of nasolabial folds. Eur J Dermatol 20:748–752PubMed Prager W, Steinkraus V (2010) A prospective, rater-blind, randomized comparison of the effectiveness and tolerability of Belotero® Basic versus Restylane® for correction of nasolabial folds. Eur J Dermatol 20:748–752PubMed
7.
go back to reference Funt D, Pavicic T (2013) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 12:295–316 Funt D, Pavicic T (2013) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 12:295–316
8.
go back to reference Tran C, Carraux P, Micheels P, Kaya G, Salomon D (2014) In vivo bio-integration of three hyaluronic acid fillers in human skin: a histological study. Dermatology 228:47–54CrossRefPubMed Tran C, Carraux P, Micheels P, Kaya G, Salomon D (2014) In vivo bio-integration of three hyaluronic acid fillers in human skin: a histological study. Dermatology 228:47–54CrossRefPubMed
9.
go back to reference Gutowski KA (2016) Hyaluronic acid fillers: science and clinical uses. Clin Plast Surg 43:489–496CrossRefPubMed Gutowski KA (2016) Hyaluronic acid fillers: science and clinical uses. Clin Plast Surg 43:489–496CrossRefPubMed
10.
go back to reference Pluda S, Pavan M, Galesso D, Guarise C (2016) Hyaluronic acid auto-crosslinked polymer (ACP): reaction monitoring, process investigation and hyaluronidase stability. Carbohydr Res 433:47–53CrossRefPubMed Pluda S, Pavan M, Galesso D, Guarise C (2016) Hyaluronic acid auto-crosslinked polymer (ACP): reaction monitoring, process investigation and hyaluronidase stability. Carbohydr Res 433:47–53CrossRefPubMed
11.
go back to reference Sparavigna A, Fino P, Tenconi B, Giordan N, Amorosi V, Scuderi N (2014) A new dermal filler made of cross-linked and auto-cross-linked hyaluronic acid in the correction of facial aging defects. J Cosmet Dermatol 13:307–314CrossRefPubMed Sparavigna A, Fino P, Tenconi B, Giordan N, Amorosi V, Scuderi N (2014) A new dermal filler made of cross-linked and auto-cross-linked hyaluronic acid in the correction of facial aging defects. J Cosmet Dermatol 13:307–314CrossRefPubMed
12.
go back to reference Alessandrini A, Fino P, Giordan N, Amorosi V, Scuderi N (2015) Evaluation of a new hyaluronic acid dermal filler for volume restoration. J Cosmet Laser Ther 17:335–342CrossRefPubMed Alessandrini A, Fino P, Giordan N, Amorosi V, Scuderi N (2015) Evaluation of a new hyaluronic acid dermal filler for volume restoration. J Cosmet Laser Ther 17:335–342CrossRefPubMed
13.
go back to reference Prasetyo AD, Prager W, Rubin MG, Moretti EA, Nikolis A (2016) Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review. Clin Cosmet Investig Dermatol 8:257–280 Prasetyo AD, Prager W, Rubin MG, Moretti EA, Nikolis A (2016) Hyaluronic acid fillers with cohesive polydensified matrix for soft-tissue augmentation and rejuvenation: a literature review. Clin Cosmet Investig Dermatol 8:257–280
14.
go back to reference Micheels P, Sarazin D, Tran C, Salomon D (2016) Effect of different crosslinking technologies on hyaluronic acid behavior: a visual and microscopic study of seven hyaluronic acid gels. J Drugs Dermatol 15(5):600–606PubMed Micheels P, Sarazin D, Tran C, Salomon D (2016) Effect of different crosslinking technologies on hyaluronic acid behavior: a visual and microscopic study of seven hyaluronic acid gels. J Drugs Dermatol 15(5):600–606PubMed
15.
go back to reference Guidelines on clinical investigation: a guide for manufacturers and notified bodies—guidelines on medical devices. In: European Commission, 2010 Guidelines on clinical investigation: a guide for manufacturers and notified bodies—guidelines on medical devices. In: European Commission, 2010
16.
go back to reference Carruthers A, Carruthers J (2010) A validated facial grading scale: the future of facial ageing measurement tools? J Cosmet Laser Ther 12:235–241CrossRefPubMed Carruthers A, Carruthers J (2010) A validated facial grading scale: the future of facial ageing measurement tools? J Cosmet Laser Ther 12:235–241CrossRefPubMed
17.
go back to reference Day DJ, Littler CM, Swift RW, Gottlieb S (2004) The wrinkle severity rating scale: a validation study. Am J Clin Dermatol 5:49–52CrossRefPubMed Day DJ, Littler CM, Swift RW, Gottlieb S (2004) The wrinkle severity rating scale: a validation study. Am J Clin Dermatol 5:49–52CrossRefPubMed
18.
go back to reference Narins RS, Brandt F, Leyden J, Lorenc ZP, Rubin M, Smith S (2003) A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg 29:588–595PubMed Narins RS, Brandt F, Leyden J, Lorenc ZP, Rubin M, Smith S (2003) A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg 29:588–595PubMed
19.
go back to reference Lindqvist C, Tveten S, Bondevik BE, Fagrell D (2005) A randomized, evaluator-blind, multicenter comparison of the efficacy and tolerability of Perlane versus Zyplast in the correction of nasolabial folds. Plast Reconstr Surg 115:282–289PubMed Lindqvist C, Tveten S, Bondevik BE, Fagrell D (2005) A randomized, evaluator-blind, multicenter comparison of the efficacy and tolerability of Perlane versus Zyplast in the correction of nasolabial folds. Plast Reconstr Surg 115:282–289PubMed
21.
go back to reference Narins RS, Coleman WPR, Donofrio LM, Jones DH, Maas C, Monheit G, Kaur M, Grundy SL, Pappert EJ, Hardas B (2010) Improvement in nasolabial folds with a hyaluronic acid filler using a cohesive polydensified matrix technology: results from an 18-month open-label extension trial. Dermatol Surg 36:1800–1808CrossRefPubMed Narins RS, Coleman WPR, Donofrio LM, Jones DH, Maas C, Monheit G, Kaur M, Grundy SL, Pappert EJ, Hardas B (2010) Improvement in nasolabial folds with a hyaluronic acid filler using a cohesive polydensified matrix technology: results from an 18-month open-label extension trial. Dermatol Surg 36:1800–1808CrossRefPubMed
22.
go back to reference Ha R, Nojima K, Adams W, Brown S (2005) Analysis of facial skin thickness: defining the relative thickness index. Plast Reconstr Surg 115:1769–1773CrossRefPubMed Ha R, Nojima K, Adams W, Brown S (2005) Analysis of facial skin thickness: defining the relative thickness index. Plast Reconstr Surg 115:1769–1773CrossRefPubMed
23.
go back to reference Rallan D, Harland CC (2003) Ultrasound in dermatology—basic principles and applications. Clin Exp Dermatol 28:632–638CrossRefPubMed Rallan D, Harland CC (2003) Ultrasound in dermatology—basic principles and applications. Clin Exp Dermatol 28:632–638CrossRefPubMed
24.
go back to reference Grippaudo FR, Mattei M (2010) High-frequency sonography of temporary and permanent dermal fillers. Skin Res Technol 16:265–269PubMed Grippaudo FR, Mattei M (2010) High-frequency sonography of temporary and permanent dermal fillers. Skin Res Technol 16:265–269PubMed
25.
go back to reference Grippaudo FR, Mattei M (2011) The utility of high-frequency ultrasound in dermal fillers evaluation. Ann Plast Surg 67:469–473CrossRefPubMed Grippaudo FR, Mattei M (2011) The utility of high-frequency ultrasound in dermal fillers evaluation. Ann Plast Surg 67:469–473CrossRefPubMed
Metadata
Title
Randomized Double-Blind Controlled Study on the Safety and Efficacy of a Novel Injectable Cross-linked Hyaluronic Gel for the Correction of Moderate-to-Severe Nasolabial Wrinkles
Authors
Pasquale Fino
Marco Toscani
Francesca Romana Grippaudo
Nicola Giordan
Nicolò Scuderi
Publication date
01-04-2019
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 2/2019
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-018-1284-x

Other articles of this Issue 2/2019

Aesthetic Plastic Surgery 2/2019 Go to the issue