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A Single Center, Prospective, Randomized, Sham-Controlled, Double-Blinded, Split-Face Trial Using Microinjections of Transparent Hyaluronic Acid Gel for Cheek Rejuvenation

Jones, Isabela T., MD*; Vanaman Wilson, Monique J., MD; Bolton, Joanna, MD; Zaleski-Larsen, Lisa, DO§; Wu, Douglas C., MD, PhD; Goldman, Mitchel P., MD

doi: 10.1097/DSS.0000000000001460
Original Article

BACKGROUND “Skin boosting” with injections of hyaluronic acid has been demonstrated to improve aged skin.

OBJECTIVE The aim of this study was to determine the efficacy and safety of small-particle hyaluronic acid with lidocaine (SP-HAL) microaliquots for the correction of fine lines of the cheeks.

MATERIALS AND METHODS Twenty subjects with mild to moderate static mid to lower cheek rhytides were enrolled. The right or left cheek was randomized to receive 1 mL of SP-HAL using a microdroplet technique, with the contralateral cheek treated with sham injection of sterile normal saline. The degree of cheek wrinkling and elastosis based on the Fitzpatrick-Goldman Wrinkle and Elastosis Scale was assessed at baseline and 7, 14, 30, 90, and 180 days after treatment. Subjects rated their satisfaction at days 90 and 180.

RESULTS Fourteen patients completed the study. There were no statistically significant improvements in wrinkling or elastosis of the SP-HAL–treated cheek or control cheek at any time point. In addition, there were no significant differences in wrinkling, elastosis, or patient satisfaction between the treatment cheek and control cheek.

CONCLUSION One treatment of intradermal microdroplet injections of SP-HAL to the mid to lower cheek failed to show superiority over normal saline in improving clinical signs of skin wrinkling and elastosis.

*McLean Dermatology and Skincare Center, McLean, Virginia;

California Skin Institute, Mountain View, California;

Alliant Dermatology, The Villages, Florida;

§West Dermatology, San Diego, California;

Goldman, Butterwick, Groff, Fabi & Wu, Cosmetic Laser Dermatology, a West Dermatology Company, San Diego, California

Address correspondence and reprint requests to: Isabela T. Jones, MD, McLean Dermatology and Skincare Center, 6849 Old Dominion Drive, Suite 300 McLean, VA 22101, or e-mail:

The authors have indicated no significant interest with commercial supporters for this study.

© 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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