<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02974985</url>
  </required_header>
  <id_info>
    <org_study_id>16-023</org_study_id>
    <nct_id>NCT02974985</nct_id>
  </id_info>
  <brief_title>A Study of the Lifting Capacity of Fillers</brief_title>
  <official_title>A Study of the Lifting Capacity of Fillers</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Abington Memorial Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Galderma R&amp;D</agency>
      <agency_class>Industry</agency_class>
    </collaborator>
  </sponsors>
  <source>Abington Memorial Hospital</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_device>Yes</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Hyaluronic acid (HA) fillers are tested in-vitro to measure their lifting capacity,&#xD;
      viscosity, cohesivity, and rheologic properties, and their lifting capacity has been tested&#xD;
      in animal models. To date, there are no studies that measure the lifting capacity of fillers&#xD;
      in an in-vivo human model.&#xD;
&#xD;
      The intention is to study the lifting capacity of fillers in a group of patients by comparing&#xD;
      pre and post-procedure two and three-dimensional photographs using analytic software.&#xD;
      Specifically, the PI is interested in determining the amount of tissue elevation created by&#xD;
      injecting HAs Restylane-Lyft®, and Restylane-L® (Galderma Laboratories, L.P., Fort Worth, TX)&#xD;
      to the midface and to the lower face, both in the anterior-posterior direction and in the&#xD;
      vertical direction by using analytic software.&#xD;
&#xD;
      The research group has identified a reliable and reproducible quantitative assessment of&#xD;
      midfacial position called WIZDOM (Width of the InterZygomatic Distance Of the Midface) to&#xD;
      quantitatively evaluate the midface. It can be used as an objective tool to assess midfacial&#xD;
      rejuvenation, whether with fat, fillers, or midface or facelift surgery. The Distance from&#xD;
      WIZDOM to inner canthus, the WIZDOM -IC measurement increases with aging as the face deflates&#xD;
      and descends, and, in the practice, is also a means of assessing the midface in youth and in&#xD;
      aging. The PI's findings have been published in the Aesthetic Surgery Journal. The practice&#xD;
      will also attempt to utilize this metric as a measure of midface aesthetic lifting capacity.&#xD;
&#xD;
      The practice will also employ 3 D photography and analytic software to determine degree of&#xD;
      lift in mm in the y and z axis. (vertical and AP increase in dimension) pre and post-&#xD;
      injection. (Vectra, Canfield, Fairfield, NJ)&#xD;
&#xD;
      We will recruit patients from a population of subjects that generally would receive fillers&#xD;
      to improve changes associated with facial volume loss and divide them in to two groups based&#xD;
      on chronologic age.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      All fillers will be injected in locations where the FDA has approved it for on-label&#xD;
      indications (the cheek, subcutaneously and supraperiosteally, the dermis and subdermis for&#xD;
      the correction of wrinkles and folds such as the nasolabial fold) and placed as usual and&#xD;
      customary using techniques as practiced by the authors and as are accepted widely.&#xD;
&#xD;
      Additional steps prior to injection for this study are temporary sterile magic marker&#xD;
      markings markers on the face and detailed photography, both 2D and 3D, that will be taken&#xD;
      before, during, and after injection, and the segmentation of injections such that the midface&#xD;
      will be injected prior to and separately from the lower face.&#xD;
&#xD;
      Three dimensional data will be analyzed using Vectra analytic software, and 2-D photographs&#xD;
      will be analyzed by measuring improvements in WIZDOM (width of the interzygomatic distance of&#xD;
      the midface) and its distance to the inner canthus.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date>April 2016</start_date>
  <completion_date type="Anticipated">March 2020</completion_date>
  <primary_completion_date type="Anticipated">September 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Degree and axes of volume shifts before and after injection of HA fillers</measure>
    <time_frame>immediately after injection</time_frame>
    <description>The investigators are using Vectra analysis software to analyze volume changes in 3D. dimensions after injection of hyaluronic acid filler.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Measurement of MMVS</measure>
    <time_frame>Two weeks post injections.</time_frame>
    <description>Medicis Midface Volume Scale</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient and Observer Satisfaction with Degree of Lift</measure>
    <time_frame>immediately after injection</time_frame>
    <description>Change in global aesthetic assessment measured from baseline.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Measure the capacity of fillers in the midface to change midface position.</measure>
    <time_frame>immediately after injection</time_frame>
    <description>H1 and Vectra analytic software: movement of measured points of reference on the face.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Measure the capacity of fillers in the midface to improve relationship between eyelid and cheek.</measure>
    <time_frame>immediately after injection</time_frame>
    <description>WIZDOM measurement and WIZDOM -IC measurement</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Measure the capacity of fillers in the midface to change lower face position.</measure>
    <time_frame>immediately after injection</time_frame>
    <description>H1 and Vectra analytic software: movement of measured points of reference on the face.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Patient-reported subjective assessment of filler effect and satisfaction</measure>
    <time_frame>Two weeks post injections.</time_frame>
    <description>GAIS Scale</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Investigator assessment of filler effect.</measure>
    <time_frame>Two weeks post injections.</time_frame>
    <description>GAIS scale</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">20</enrollment>
  <condition>Esthetic &amp; Topographic Shifts From Facial Fillers</condition>
  <arm_group>
    <arm_group_label>Women aged 40-50</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Intervention--Injections of volumizing products Restylane L and Restylane Lyft with endpoint &quot; a dramatic result is seen that is agreed upon by both subject and injector&quot;. The number of injections will be determined (and quantified) by both the patient and the PI to achieve this endpoint.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Women aged 50-60</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Intervention--Injections of volumizing products Restylane L and Restylane Lyft with endpoint &quot; a dramatic result is seen that is agreed upon by both subject and injector&quot;. The number of injections will be determined (and quantified) by both the patient and the PI to achieve this endpoint.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>injection of Restylane Lyft and Restylane L</intervention_name>
    <description>Intervention--Injections of volumizing products to the midface, nasolabial fold, and marionette folds in female patients in two different age groups</description>
    <arm_group_label>Women aged 40-50</arm_group_label>
    <arm_group_label>Women aged 50-60</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Women ages 40-60&#xD;
&#xD;
          -  Midface, lower face volume loss and gravitational changes amenable to the&#xD;
             administration of HA fillers.&#xD;
&#xD;
          -  Filler requirements, based on experienced injector assessment, on the order of 8&#xD;
             syringes.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  History of prior filler injections in the past 12 months.&#xD;
&#xD;
          -  Pregnancy/planned pregnancy&#xD;
&#xD;
          -  Allergy to HA products&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <minimum_age>40 Years</minimum_age>
    <maximum_age>60 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Allan E Wulc, M.D.</last_name>
    <role>Principal Investigator</role>
    <affiliation>Abington Hospital</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Allan E Wulc, M.D</last_name>
    <phone>610-828-8880</phone>
    <email>awulcmd@gmail.com</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Deborah Tuccillo, RN</last_name>
    <phone>610-828-8880</phone>
    <email>debbie@wcosmeticsurgery.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>W Cosmetic Surgery</name>
      <address>
        <city>Plymouth Meeting</city>
        <state>Pennsylvania</state>
        <zip>19462</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Allan E Wulc, M.D.</last_name>
      <phone>610-828-8880</phone>
      <email>awulcmd@gmail.com</email>
    </contact>
    <contact_backup>
      <last_name>Deborah Tuccillo, RN</last_name>
      <phone>610-828-8880</phone>
      <email>debbie@wcosmeticsurgery.com</email>
    </contact_backup>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <link>
    <url>http://www.galderma.com</url>
    <description>Device Company website with FDA prescribing information and warnings</description>
  </link>
  <link>
    <url>http://www.wcosmeticsurgery.com</url>
    <description>PI corporate website</description>
  </link>
  <reference>
    <citation>Little JW. Volumetric perceptions in midfacial aging with altered priorities for rejuvenation. Plast Reconstr Surg. 2000 Jan;105(1):252-66; discussion 286-9. doi: 10.1097/00006534-200001000-00043.</citation>
    <PMID>10626998</PMID>
  </reference>
  <reference>
    <citation>Kablik J, Monheit GD, Yu L, Chang G, Gershkovich J. Comparative physical properties of hyaluronic acid dermal fillers. Dermatol Surg. 2009 Feb;35 Suppl 1:302-12. doi: 10.1111/j.1524-4725.2008.01046.x.</citation>
    <PMID>19207319</PMID>
  </reference>
  <reference>
    <citation>Swift A, Remington K. BeautiPHIcation: a global approach to facial beauty. Clin Plast Surg. 2011 Jul;38(3):347-77, v. doi: 10.1016/j.cps.2011.03.012.</citation>
    <PMID>21824535</PMID>
  </reference>
  <reference>
    <citation>Ramirez OM. Three-dimensional endoscopic midface enhancement: a personal quest for the ideal cheek rejuvenation. Plast Reconstr Surg. 2002 Jan;109(1):329-40; discussion 341-9. doi: 10.1097/00006534-200201000-00052.</citation>
    <PMID>11786834</PMID>
  </reference>
  <reference>
    <citation>Surek CC, Beut J, Stephens R, Jelks G, Lamb J. Pertinent anatomy and analysis for midface volumizing procedures. Plast Reconstr Surg. 2015 May;135(5):818e-829e. doi: 10.1097/PRS.0000000000001226.</citation>
    <PMID>25919264</PMID>
  </reference>
  <reference>
    <citation>Borrell M, Leslie DB, Tezel A. Lift capabilities of hyaluronic acid fillers. J Cosmet Laser Ther. 2011 Feb;13(1):21-7. doi: 10.3109/14764172.2011.552609. Epub 2011 Jan 21.</citation>
    <PMID>21254807</PMID>
  </reference>
  <reference>
    <citation>Pierre S, Liew S, Bernardin A. Basics of dermal filler rheology. Dermatol Surg. 2015 Apr;41 Suppl 1:S120-6. doi: 10.1097/DSS.0000000000000334.</citation>
    <PMID>25828036</PMID>
  </reference>
  <reference>
    <citation>Gold M. The science and art of hyaluronic acid dermal filler use in esthetic applications. J Cosmet Dermatol. 2009 Dec;8(4):301-7. doi: 10.1111/j.1473-2165.2009.00464.x.</citation>
    <PMID>19958435</PMID>
  </reference>
  <reference>
    <citation>Beer K, Lupo MP. Making the right choices: attaining predictable aesthetic results with dermal fillers. J Drugs Dermatol. 2010 May;9(5):458-65.</citation>
    <PMID>20480788</PMID>
  </reference>
  <reference>
    <citation>Carruthers J, Flynn TC, Geister TL, Gortelmeyer R, Hardas B, Himmrich S, Jones D, Kerscher M, de Maio M, Mohrmann C, Narins RS, Pooth R, Rzany B, Sattler G, Buchner L, Benter U, Breitscheidel L, Carruthers A. Validated assessment scales for the mid face. Dermatol Surg. 2012 Feb;38(2 Spec No.):320-32. doi: 10.1111/j.1524-4725.2011.02251.x.</citation>
    <PMID>22316188</PMID>
  </reference>
  <reference>
    <citation>Linkov G, Mally P, Czyz CN, Wulc AE. Quantification of the Aesthetically Desirable Female Midface Position. Aesthet Surg J. 2018 Feb 15;38(3):231-240. doi: 10.1093/asj/sjx122.</citation>
    <PMID>29040391</PMID>
  </reference>
  <verification_date>July 2018</verification_date>
  <study_first_submitted>November 10, 2016</study_first_submitted>
  <study_first_submitted_qc>November 23, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">November 29, 2016</study_first_posted>
  <last_update_submitted>July 7, 2018</last_update_submitted>
  <last_update_submitted_qc>July 7, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">July 10, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Abington Memorial Hospital</investigator_affiliation>
    <investigator_full_name>Allan Wulc</investigator_full_name>
    <investigator_title>Allan E. Wulc, M.D., F.A.C.S</investigator_title>
  </responsible_party>
  <keyword>Facelift</keyword>
  <keyword>HA Filler</keyword>
  <keyword>Hyaluronic acid</keyword>
  <keyword>Facial Rejuvenation</keyword>
  <keyword>Aging Face</keyword>
  <keyword>WIZDOM</keyword>
  <keyword>Midface lift</keyword>
  <keyword>Midface augmentation</keyword>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Hyaluronic Acid</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
    <ipd_description>will make protocols and statistics and photos available to all interested including esearch collaborators.</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02974985
org study id: 16-023
nct id: NCT02974985
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated device: Yes
Hyaluronic acid (HA) fillers are tested in-vitro to measure their lifting capacity,
      viscosity, cohesivity, and rheologic properties, and their lifting capacity has been tested
      in animal models. To date, there are no studies that measure the lifting capacity of fillers
      in an in-vivo human model.

      The intention is to study the lifting capacity of fillers in a group of patients by comparing
      pre and post-procedure two and three-dimensional photographs using analytic software.
      Specifically, the PI is interested in determining the amount of tissue elevation created by
      injecting HAs Restylane-Lyft®, and Restylane-L® (Galderma Laboratories, L.P., Fort Worth, TX)
      to the midface and to the lower face, both in the anterior-posterior direction and in the
      vertical direction by using analytic software.

      The research group has identified a reliable and reproducible quantitative assessment of
      midfacial position called WIZDOM (Width of the InterZygomatic Distance Of the Midface) to
      quantitatively evaluate the midface. It can be used as an objective tool to assess midfacial
      rejuvenation, whether with fat, fillers, or midface or facelift surgery. The Distance from
      WIZDOM to inner canthus, the WIZDOM -IC measurement increases with aging as the face deflates
      and descends, and, in the practice, is also a means of assessing the midface in youth and in
      aging. The PI's findings have been published in the Aesthetic Surgery Journal. The practice
      will also attempt to utilize this metric as a measure of midface aesthetic lifting capacity.

      The practice will also employ 3 D photography and analytic software to determine degree of
      lift in mm in the y and z axis. (vertical and AP increase in dimension) pre and post-
      injection. (Vectra, Canfield, Fairfield, NJ)

      We will recruit patients from a population of subjects that generally would receive fillers
      to improve changes associated with facial volume loss and divide them in to two groups based
      on chronologic age.
All fillers will be injected in locations where the FDA has approved it for on-label
      indications (the cheek, subcutaneously and supraperiosteally, the dermis and subdermis for
      the correction of wrinkles and folds such as the nasolabial fold) and placed as usual and
      customary using techniques as practiced by the authors and as are accepted widely.

      Additional steps prior to injection for this study are temporary sterile magic marker
      markings markers on the face and detailed photography, both 2D and 3D, that will be taken
      before, during, and after injection, and the segmentation of injections such that the midface
      will be injected prior to and separately from the lower face.

      Three dimensional data will be analyzed using Vectra analytic software, and 2-D photographs
      will be analyzed by measuring improvements in WIZDOM (width of the interzygomatic distance of
      the midface) and its distance to the inner canthus.
allocation: Non-Randomized
intervention model: Single Group Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Degree and axes of volume shifts before and after injection of HA fillers
time frame: immediately after injection
description: The investigators are using Vectra analysis software to analyze volume changes in 3D. dimensions after injection of hyaluronic acid filler.
measure: Measurement of MMVS
time frame: Two weeks post injections.
description: Medicis Midface Volume Scale
measure: Patient and Observer Satisfaction with Degree of Lift
time frame: immediately after injection
description: Change in global aesthetic assessment measured from baseline.
measure: Measure the capacity of fillers in the midface to change midface position.
time frame: immediately after injection
description: H1 and Vectra analytic software: movement of measured points of reference on the face.
measure: Measure the capacity of fillers in the midface to improve relationship between eyelid and cheek.
time frame: immediately after injection
description: WIZDOM measurement and WIZDOM -IC measurement
measure: Measure the capacity of fillers in the midface to change lower face position.
time frame: immediately after injection
description: H1 and Vectra analytic software: movement of measured points of reference on the face.
measure: Patient-reported subjective assessment of filler effect and satisfaction
time frame: Two weeks post injections.
description: GAIS Scale
measure: Investigator assessment of filler effect.
time frame: Two weeks post injections.
description: GAIS scale
arm group label: Women aged 40-50
arm group type: Experimental
description: Intervention--Injections of volumizing products Restylane L and Restylane Lyft with endpoint " a dramatic result is seen that is agreed upon by both subject and injector". The number of injections will be determined (and quantified) by both the patient and the PI to achieve this endpoint.
arm group label: Women aged 50-60
arm group type: Experimental
description: Intervention--Injections of volumizing products Restylane L and Restylane Lyft with endpoint " a dramatic result is seen that is agreed upon by both subject and injector". The number of injections will be determined (and quantified) by both the patient and the PI to achieve this endpoint.
intervention type: Device
intervention name: injection of Restylane Lyft and Restylane L
description: Intervention--Injections of volumizing products to the midface, nasolabial fold, and marionette folds in female patients in two different age groups
arm group label: Women aged 40-50
arm group label: Women aged 50-60
criteria: 
gender: Female
minimum age: 40 Years
maximum age: 60 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Allan E Wulc, M.D.
role: Principal Investigator
affiliation: Abington Hospital
last name: Allan E Wulc, M.D
phone: 610-828-8880
email: awulcmd@gmail.com
last name: Deborah Tuccillo, RN
phone: 610-828-8880
email: debbie@wcosmeticsurgery.com
facility: 
status: Recruiting
contact: 
contact backup: 
country: United States
url: http://www.galderma.com
description: Device Company website with FDA prescribing information and warnings
url: http://www.wcosmeticsurgery.com
description: PI corporate website
citation: Little JW. Volumetric perceptions in midfacial aging with altered priorities for rejuvenation. Plast Reconstr Surg. 2000 Jan;105(1):252-66; discussion 286-9. doi: 10.1097/00006534-200001000-00043.
PMID: 10626998
citation: Kablik J, Monheit GD, Yu L, Chang G, Gershkovich J. Comparative physical properties of hyaluronic acid dermal fillers. Dermatol Surg. 2009 Feb;35 Suppl 1:302-12. doi: 10.1111/j.1524-4725.2008.01046.x.
PMID: 19207319
citation: Swift A, Remington K. BeautiPHIcation: a global approach to facial beauty. Clin Plast Surg. 2011 Jul;38(3):347-77, v. doi: 10.1016/j.cps.2011.03.012.
PMID: 21824535
citation: Ramirez OM. Three-dimensional endoscopic midface enhancement: a personal quest for the ideal cheek rejuvenation. Plast Reconstr Surg. 2002 Jan;109(1):329-40; discussion 341-9. doi: 10.1097/00006534-200201000-00052.
PMID: 11786834
citation: Surek CC, Beut J, Stephens R, Jelks G, Lamb J. Pertinent anatomy and analysis for midface volumizing procedures. Plast Reconstr Surg. 2015 May;135(5):818e-829e. doi: 10.1097/PRS.0000000000001226.
PMID: 25919264
citation: Borrell M, Leslie DB, Tezel A. Lift capabilities of hyaluronic acid fillers. J Cosmet Laser Ther. 2011 Feb;13(1):21-7. doi: 10.3109/14764172.2011.552609. Epub 2011 Jan 21.
PMID: 21254807
citation: Pierre S, Liew S, Bernardin A. Basics of dermal filler rheology. Dermatol Surg. 2015 Apr;41 Suppl 1:S120-6. doi: 10.1097/DSS.0000000000000334.
PMID: 25828036
citation: Gold M. The science and art of hyaluronic acid dermal filler use in esthetic applications. J Cosmet Dermatol. 2009 Dec;8(4):301-7. doi: 10.1111/j.1473-2165.2009.00464.x.
PMID: 19958435
citation: Beer K, Lupo MP. Making the right choices: attaining predictable aesthetic results with dermal fillers. J Drugs Dermatol. 2010 May;9(5):458-65.
PMID: 20480788
citation: Carruthers J, Flynn TC, Geister TL, Gortelmeyer R, Hardas B, Himmrich S, Jones D, Kerscher M, de Maio M, Mohrmann C, Narins RS, Pooth R, Rzany B, Sattler G, Buchner L, Benter U, Breitscheidel L, Carruthers A. Validated assessment scales for the mid face. Dermatol Surg. 2012 Feb;38(2 Spec No.):320-32. doi: 10.1111/j.1524-4725.2011.02251.x.
PMID: 22316188
citation: Linkov G, Mally P, Czyz CN, Wulc AE. Quantification of the Aesthetically Desirable Female Midface Position. Aesthet Surg J. 2018 Feb 15;38(3):231-240. doi: 10.1093/asj/sjx122.
PMID: 29040391
responsible party type: Principal Investigator
investigator affiliation: Abington Memorial Hospital
investigator full name: Allan Wulc
investigator title: Allan E. Wulc, M.D., F.A.C.S
mesh term: Hyaluronic Acid
sharing ipd: Undecided
ipd description: will make protocols and statistics and photos available to all interested including esearch collaborators.