The use of hyaluronic acid (HA) fillers for soft tissue augmentation offers a valuable treatment modality for the correction of chin retrusion (i.e., when the chin appears to be set back or further back than normal in relation to the rest of the face). Their use is well-tolerated and provides satisfactory aesthetic results by improving facial balance and projection. Although the efficacy of hyaluronic acid HA fillers for chin augmentation has been established, the specific anatomy of the region may lead to adverse events. More specifically, certain fillers with strong integration characteristics may lead to product migration, while others with poor integration characteristics may lead to palpable deformities and distortion of the surrounding injection tissues.

Using a filler that has a high concentration of hyaluronic acid, a medium level of firmness and low water absorption may offer an effective option for treating this indication while minimizing certain adverse events. In addition, using consistent, standardized injection techniques can help achieve an ideal result.

We believe that the use of a novel HA gel (Revanesse Sculp+) for the chin, with a high concentration of HA, a moderate firmness and low water absorption, will perform better than historical controls with firmer properties in the management of chin retrusion.

Inclusion Criteria:

1. At the time of consent, male and female participants 18 years of age and older;
2. Participants with established chin retrusion at Baseline (a score of minimal, moderate or severe; based on the Treating Investigator's Allergan Chin Retrusion Scale(ACRS)1 assessment;
3. Accepted the obligation not to receive any other facial procedures throughout the study duration;
4. Understood and accepted the obligation and would be logistically able to appear for all scheduled follow-up visits;
5. No previous lower face fillers for 12 months prior to this study;
6. Capable of providing informed consent;
7. Willing to undergo scheduled CT scans as part of the study design;
8. Females of childbearing potential agree to take a scheduled urinary pregnancy test (UPT) prior to treatment administration.

Exclusion Criteria:

1. Participants without chin retrusion at Screening, per the ACRS1 ;

2. Participants with extreme chin retrusion at Screening as per the ACRS1;

3. Current Pregnancy or lactation [sexually active women of childbearing age must agree to use medically acceptable methods of contraception for the duration of this study (e.g., oral contraceptives, condoms, intrauterine device, shot/injection, patch)];

4. Hypersensitivity to Revanesse products, hyaluronic acid filler or amide local anesthetics;

5. Participants presenting with porphyria or any other liver diseases;

6. Inability to comply with follow-up and abstain from facial injections during the study period;

7. Heavy smokers, classified as smoking more than 12 cigarettes per day;

8. History of severe or multiple allergies manifested by anaphylaxis, since drug allergies might preclude optimal management of complications;

9. Previous tissue revitalization therapy in the treatment area (i.e., the lower face) within 6 months before treatment with laser or light, mesotherapy, radiofrequency, ultrasound, cryotherapy, chemical peeling, or dermabrasion;

10. Previous facial surgery, including liposuction;

11. Lifetime history of permanent implants in the treatment region (i.e., the lower face) including but not limited to dental implants;

12. Lifetime history of semi-permanent dermal fillers in the treatment region (i.e., the lower face);

13. History or presence of any disease or lesion near or at the treatment area, including inflammation, active or chronic infection, including in the mouth, dentals, head and neck region;

14. Active facial psoriasis, eczema, acne, rosacea, perioral dermatitis, herpes zoster or any other facial condition that may increase the risk of cutaneous penetration of infective agents;

15. Scars, deformities, piercing, or tattoos in the treatment areas;

16. Facial cancer or precancer (e.g., actinic keratosis);

17. History of radiation therapy to the treatment area;

18. History of bleeding disorders, or treatment with thrombolytics, anticoagulants, or inhibitors of platelet aggregation (e.g., Aspirin or other non-steroid anti-inflammatory drugs [NSAIDs]), within 2 weeks before treatment;

19. Participants with immune disorders such as systemic lupus erythematosus, rheumatoid arthritis, mixed connective tissue disease, and Hashimoto's thyroiditis, or participants using immunosuppressants;

20. Participants with a tendency to form hypertrophic or keloid scars, or any other healing disorders;

21. Participants with a tendency to form post-inflammatory hyperpigmentation;

22. Participants with known hypersensitivity to lidocaine or agents structurally related to amide type local anaesthetics (e.g., certain anti-arrhythmic);

23. Participants administered dental block or topical administration of lidocaine within 2 weeks of treatment;

24. Participants with epilepsy, impaired cardiac conduction, severely impaired hepatic function or severe renal dysfunction;

25. Current remote infections (e.g., urinary tract, sinuses, intestinal tract, oral cavity);

26. Planned dental procedures during the 2-week period before and after filler treatments, including teeth cleaning, tooth extraction and gum grafts;

27. Planned vaccinations during the 2-week period before and after filler treatments;

28. Lifetime history of cystic acne, due to increased risk of cyst development following filler treatment;

29. CT scan reveals any bone-related abnormality (e.g., Osteoporosis, Paget's disease, bone infection or cancer), deformity, growths or anything in the Primary Investigator's opinion would interfere with the assessment of any endpoint;

30. Participant is undergoing orthodontic procedures/treatments that manipulate the teeth and underlying bone structure including but not limited to braces and Invisalign treatments;

31. Participants who cannot/should not, for any reason (medical or otherwise), undergo scheduled CT scans (i.e., due to increased safety risks);

32. History of clinically significant medical conditions or any other reason that the investigator determines would interfere with the participants participation in this study or would make the participant an unsuitable candidate to receive study medical device;

    • Diagnosed myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis, or any other significant disease that might interfere with neuromuscular function
    • History of facial nerve palsy
    • Infection or dermatological condition at the treatment injection sites
    • Marked facial dermatochalasis, deep dermal scarring, excessively thick sebaceous skin, or excessively photodamaged skin

33. Participant has an anticipated need for overnight hospitalization or scheduled surgery;

34. Participant has been treated with any other investigational product at least 30 days before the first administration of the current investigational product.