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Novel Hyaluronic Acid Dermal Filler: Dermal Gel Extra Physical Properties and Clinical Outcomes

BACKGROUND Dermal gel extra (DGE) is a new, tightly cross‐linked hyaluronic acid (HA)‐based dermal filler containing lidocaine engineered to resist gel deformation and degradation. OBJECTIVES To develop a firmer gel product (DGE) and compare the efficacy and safety of DGE with nonanimal stabilized HA (NASHA) for correction of nasolabial folds (NLFs). METHODS DGE physical properties were characterized, and 140 subjects with moderate to deep NLFs were treated with DGE and NASHA in a randomized, multicenter, split‐face design study. Efficacy, pain, and satisfaction were measured using appropriate standard instruments. Adverse events were monitored throughout the study. RESULTS DGE has a higher modulus and a higher gel:fluid ratio than other HA fillers. Similar optimal correction was observed with DGE and NASHA through 36 weeks (9 months). Study subjects required less volume (p<.001) and fewer touch‐ups (p=.005) and reported less injection pain (p<.001) with DGE treatment. Most adverse events were mild to moderate skin reactions. CONCLUSIONS DGE is a firm HA gel that required significantly less volume and fewer touch‐ups to provide equivalent efficacy to NASHA for NLF correction; both dermal gels were well tolerated. DGE will provide a comfortable and cost‐effective dermal filler option for clinicians and patients. This trial was sponsored by Mentor Worldwide LLC, Santa Barbara, CA and Genzyme Corporation, Cambridge, MA. Drs. Monheit and Gold are consultants to Mentor. David Burkholder, PhD, is an employee of PD Pharmaceutical Consulting Services, LLC, Guilford, CT. He is a Mentor writing consultant and was paid by the sponsors to provide assistance in the preparation of the manuscript.