A Study of Treatment Preference During Cheek Contouring Comparing Restylane® SubQ With and Without the Addition of Lidocaine Hydrochloride

• Subject Assessment of pain [ Time Frame: Up to 2 hours after injection ] [ Designated as safety issue: No ]
  To evaluate subject assessment of pain during the first 2 hours after injection of Restylane SubQ with and without the addition of lidocaine hydrochloride 0.3%, using a visual analogue scale (VAS).
• Efficacy in terms of Global Esthetic Improvement Scale (GEIS) score [ Time Frame: 2 weeks, 3, 6, 9 and 12 months after treatment ] [ Designated as safety issue: No ]
  To evaluate the efficacy in terms of GEIS score as assessed by the Investigator and subject, respectively, per treatment group.
• Efficacy in terms of Medicis Midface Volume Scale (MMVS) [ Time Frame: Screening (day -14 to 0), 2 weeks, 3, 6, 9 and 12 months after treatment ] [ Designated as safety issue: No ]
  To evaluate the efficacy in terms of Medicis Midface Volume Scale (MMVS) as assessed by the Investigator per treatment group.
• Subject Diary [ Time Frame: Up to two weeks after treatment ] [ Designated as safety issue: Yes ]
  To evaluate the acute safety profile, elicited by subject diary used daily for 2 weeks after injection per treatment group
• Adverse Events [ Time Frame: Up to 12 months ] [ Designated as safety issue: Yes ]
  To evaluate safety throughout the study period per treatment group.

• Subject Assessment of pain [ Time Frame: Up to 2 hours after injection ] [ Designated as safety issue: No ]
  To evaluate subject assessment of pain during the first 2 hours after injection of Restylane SubQ with and without the addition of lidocaine hydrochloride 0.3%, using a visual analogue scale (VAS).
• Efficacy in terms of Global Esthetic Improvement Scale (GEIS) score [ Time Frame: 2 weeks, 3, 6, 9 and 12 months after treatment ] [ Designated as safety issue: No ]
  To evaluate the efficacy in terms of GEIS score as assessed by the Investigator and subject, respectively, per treatment group.
• Efficacy in terms of Medicis Midface Volume Scale (MMVS) [ Time Frame: Screening (day -14 to 0), 2 weeks, 3, 6, 9 and 12 months after treatment ] [ Designated as safety issue: No ]
  To evaluate the efficacy in terms of Medicis Midface Volume Scale (MMVS) as assessed by the Investigator per treatment group.
• Acute safety profile [ Time Frame: Up to two weeks after treatment ] [ Designated as safety issue: Yes ]
  To evaluate the acute safety profile, elicited by subject diary used daily for 2 weeks after injection and adverse events collected from the subject and by Investigator assessment of findings at day of treatment, and at 2-week-visit, per treatment group.
• Long-term safety profile [ Time Frame: Up to 12 months ] [ Designated as safety issue: Yes ]
  To evaluate safety throughout the study period per treatment group.
• Placement of gel [ Time Frame: 2 weeks and 3 months ] [ Designated as safety issue: No ]
  To evaluate in a subpopulation of the subjects, by ultrasound, the placement of the gel using the sharp needle and blunt microcannula, respectively.

The objectives of this study are to evaluate the pain-relieving effect and safety of adding lidocaine hydrochloride to Restylane SubQ and to evaluate the esthetic improvement obtained. The study products will be administered in the cheek.

The Restylane SubQ gel is intended to be used for facial tissue augmentation. The lidocaine content is designed to reduce the subject's pain during treatment. The objectives of this split-face designed study are to evaluate the pain-relieving effect and safety of adding lidocaine hydrochloride to Restylane SubQ and to evaluate the esthetic improvement obtained with the dermal filler using the global esthetic improvement scale (GEIS).

• Device: Restylane SubQ
  Treatment with up to 2 ml of the product
• Device: Restylane SubQ Lidocaine
  Treatment with up to 2 ml of the product

• Restylane SubQ
  Intervention: Device: Restylane SubQ
• Restylane SubQ Lidocaine
  Intervention: Device: Restylane SubQ Lidocaine

Inclusion Criteria:

• 18 years of age or older.
• Intent to undergo contouring of both cheeks with 1.5 to 2 ml Restylane SubQ per cheek.
• Sufficient symmetry of the face in order to ensure similar volume to be injected, similar injection technique and time for injection.
• Signed informed consent.

Exclusion Criteria:

• Surgery in the midface including aesthetic facial surgical therapy, sinus surgery or dental root surgery within the past 12 months.
• Chronic infection in head and neck region.
• Ongoing infections in mouth.
• Tendency for edema, puffiness or swelling over the zygomatic prominence.
• Active skin disease, inflammation or related conditions, such as infection, psoriasis and herpes zoster near or on the area to be treated.
• Previous hypersensitivity to hyaluronic acid or local anesthetics.
• Concomitant anticoagulant therapy and therapy with inhibitors of platelet aggregation within 10 days prior to treatment, or a history of bleeding disorders.
• Cancerous or pre-cancerous lesions in the area to be treated.
• Previous tissue augmenting therapy in the area to be treated with non-permanent filler, laser treatment, or chemical peeling during the last 6 months.
• Permanent implant placed in the area to be treated.
• Reduced sensibility in the facial region e.g. due to trauma, facial pareses, previous tissue augmenting therapy, aesthetic facial surgical therapy, laser treatment, or peeling.
• Pregnancy or breast feeding.
• Participation in any other clinical study within 30 days prior to inclusion.
• Other condition preventing the subject to entering the study in the Investigator's opinion e.g. subjects not likely to avoid other facial cosmetic treatments below the level of the upper orbital rim, subjects anticipated to be unreliable or incapable of understanding the VAS assessment, insufficient tissue support or cover of the treatment area.