A Multicenter, Double-Blind, Randomized, Split-Face Study to Evaluate the Safety and Efficacy of Revanesse® Ultra + (with Lidocaine) versus Revanesse® Ultra for the Correction of Nasolabial Folds to compare the safety and efficacy profiles of Revanesse® Ultra + (with lidocaine, hereafter referred to as Revanesse Ultra +) to Revanesse Ultra for subjects undergoing correction of nasolabial folds (NLFs)

This is a randomized, multicenter, double-blind, split-face study in subjects seeking nasolabial fold correction. Subjects will be treated with Revanesse Ultra + in the NLF on one side of the face and Revanesse Ultra in the NLF on the other side of the face. The side of the face for each study product will be randomly assigned. The investigator and the subject will be blinded to the treatment; injections of the study product will be performed by an unblinded injecting investigator.

At each visit, investigator and subject evaluations of the treated areas will be performed and recorded

Inclusion Criteria:

• Subjects must meet all of the following criteria to be eligible for the study:

  1. Men or women 22 years of age or older seeking augmentation therapy for correction of bilateral nasolabial folds.
  2. Two fully visible bilateral nasolabial folds each with a Wrinkle Severity Rating Scale Score (WSRS) of 3 or 4 that may be corrected with an injectable dermal filler. The NLFs should be symmetrical, i.e., WSRS scores at NLFs on both sides should be the same (both Moderate [3] or both Severe [4]).
  3. If female and of childbearing potential, a negative urine pregnancy test and agree to use adequate contraception. Female subjects of childbearing potential (excluding women who are surgically sterilized or postmenopausal for at least 2 years) must have a negative urine pregnancy test and must be willing to use a medically accepted method of contraception during the study. The following are considered acceptable methods of birth control for the purpose of this study: oral contraceptives, contraceptive patches, contraceptive implant, vaginal contraceptive, double barrier methods (e.g., condom and spermicide), contraceptive injection (Depo-Provera®), intrauterine device (IUD), hormonal IUD (Mirena®), and abstinence with a documented second acceptable method of birth control if the subject becomes sexually active. Subjects entering the study who are on hormonal contraceptives must have been on the method for at least 90 days prior to the study and continue the method for the duration of the study. Subjects who had used hormonal contraception and stopped must have stopped no less than 90 days prior to Visit 1/Day 1.
  4. Ability to understand and comply with the requirements of the study.
  5. Willingness and ability to provide written informed consent. 6. Agree to refrain from seeking other treatment for this condition during the study.

Exclusion Criteria:

Subjects who meet any of the following criteria will be excluded from the study:

1. Wrinkle Severity Rating Scale Score of ≤ 2 on the right or left nasolabial fold.
2. Women who are pregnant or lactating.
3. Received prior dermabrasion, facelift, or Botox below the orbital rim, or had undergone procedures based on active dermal response (e.g., laser or chemical peeling procedures) within 6 months (180 days) prior to study entry.
4. Use of any facial tissue augmenting therapy with non-permanent filler or aesthetic facial surgical therapy within 9 months prior to study entry.
5. Has ever received semi-permanent fillers anywhere in the face or neck, or is planning to be implanted with these products during the study.
6. Has a permanent implant placed in the NLF area.
7. Evidence of scar-related disease or delayed healing activity within the past 1 year.
8. Scars at the intended treatment sites.
9. History of keloid formation or hypertrophic scars.
10. Any infection or unhealed wound on the face.
11. Allergic history including anaphylaxis, multiple severe allergies, atopy, or allergies to natural rubber latex, lidocaine or any amide-based anesthetic, hyaluronic acid products, or Streptococcal proteins or have plans to undergo desensitization therapy during the term of the study.
12. Aspirin or nonsteroidal anti-inflammatory drugs within 1 week (7 days) prior to treatment.
13. Concomitant anticoagulant therapy, antiplatelet therapy, or history of bleeding disorders, coagulation defects or connective tissue disorders.
14. Over-the-counter (OTC) wrinkle products or prescription wrinkle treatments within 4 weeks (28 days) prior to treatment and throughout the study.
15. Immunocompromised or immunosuppressed.
16. Clinically significant organic disease including clinically significant cardiovascular, hepatic, pulmonary, neurologic, or renal disease or other medical condition, serious intercurrent illness, or extenuating circumstance that, in the opinion of the investigator, preclude participation in the trial.
17. Received any investigational product within 30 days of signing the Informed Consent Form.
18. Facial tattoo that may interfere with diagnosis.
19. Systemic (oral/injectable) corticosteroids or immunosuppressive medications within 30 days prior to treatment and topical steroids on the face within 14 days prior to treatment start and throughout the study.
20. Acne and/or other inflammatory diseases of the skin.
21. Acute or chronic skin disease, inflammation or related conditions, cancerous or precancerous lesions on or near the injection sites.-

There were 100 subjects randomized, in accordance with the inclusion / exclusion criteria, who were men or women at least 22 years of age with two fully visible bilateral nasolabial folds each with a Wrinkle Severity Rating Scale (WSRS) score of 3 or 4 (moderate or severe)

Each subject was monitored for the occurrence of AEs, including SAEs, immediately after treatment initiation. Each subject was followed for safety monitoring until discharged from the study. Follow-up procedures related to pregnancy or AEs or SAEs could continue beyond the end of the study. Adverse event data was collected over a 10 month period of time.

The side of the face for each product was randomly assigned. The investigator performing the evaluations and the subject were blinded to the treatment; injections of the study product were performed by an unblinded injecting investigator.