K Number
K192423
Device Name
MINT Product Family
Date Cleared
2020-09-09

(371 days)

Product Code
Regulation Number
878.4840
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
MINT™ is indicated for use in mid-face suspension surgery to temporarily fixate the cheek subcutaneous fat layer and SMAS layer in an elevated position for the treatment of moderate to severe nasolabial folds.
Device Description
The MINT™ device is a sterile synthetic absorbable surgical suture comprised of polydioxanone, (GHoOJ)n. Polydioxanone has been found to be nonantigenic and to elicit only a slight tissue reaction during absorption. The pigment of the violet dye is D&C Violet No.2 (21CFR §74.3602). MINT™ is available in a range of gauge sizes and lengths. Each suture has bi-directional barbs along the long axis of the suture monofilament. The MINT™ Synthetic Absorbable PDO suture approximates tissues, without the need to tie surgical knots, by using the opposing barbs on the suture surface to embed in the tissues after the surgeon precisely places the suture within the tissues. Barbed suture lifting is a minimally invasive surgical technique for facial rejuvenation. The MINT™ Product Family includes models which are supplied with needles. For those models supplied with a needle, designated as "Lifting Thread Combined with needle" in the MINT™ Product Family instructions for use, the needle is used to make the insertion point and for threading of the suture in the patient's dermis.
More Information

No
The device description and performance studies focus on the physical properties and clinical outcomes of a surgical suture, with no mention of AI or ML technology.

Yes
The device is intended for the treatment of moderate to severe nasolabial folds by temporarily fixating the cheek subcutaneous fat layer and SMAS layer in an elevated position, thereby providing a therapeutic effect by improving the condition.

No
The provided text describes the MINT™ device as a surgical suture used for mid-face suspension surgery to treat nasolabial folds, which is a therapeutic purpose, not a diagnostic one. It does not mention any function for identifying or characterizing a disease or condition.

No

The device description clearly states that MINT™ is a sterile synthetic absorbable surgical suture comprised of polydioxanone, which is a physical material. The summary also details non-clinical, animal, and clinical performance data related to the physical properties and performance of the suture and associated needles. There is no mention of software as a component of this device.

Based on the provided information, the MINT™ device is not an In Vitro Diagnostic (IVD).

Here's why:

  • Intended Use: The intended use is for "mid-face suspension surgery to temporarily fixate the cheek subcutaneous fat layer and SMAS layer in an elevated position for the treatment of moderate to severe nasolabial folds." This describes a surgical procedure performed directly on the patient's body for a cosmetic/reconstructive purpose.
  • Device Description: The device is a "sterile synthetic absorbable surgical suture comprised of polydioxanone." This is a physical implantable material used in surgery.
  • Lack of IVD Characteristics: The description does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing samples from the human body (blood, urine, tissue, etc.).
    • Providing information about a patient's health status, diagnosis, or disease.
    • Using reagents or assays.

The device is a surgical implant used to physically lift and support tissue, which falls under the category of a surgical device, not an in vitro diagnostic device.

N/A

Intended Use / Indications for Use

MINT™ is indicated for use in mid-face suspension surgery to temporarily fixate the cheek subcutaneous fat layer and SMAS layer in an elevated position for the treatment of moderate to severe nasolabial folds.

Product codes

NEW

Device Description

The MINT™ device is a sterile synthetic absorbable surgical suture comprised of polydioxanone, (GHoOJ)n. Polydioxanone has been found to be nonantigenic and to elicit only a slight tissue reaction during absorption. The pigment of the violet dye is D&C Violet No.2 (21CFR §74.3602). MINT™ is available in a range of gauge sizes and lengths.

Each suture has bi-directional barbs along the long axis of the suture monofilament. The MINT™ Synthetic Absorbable PDO suture approximates tissues, without the need to tie surgical knots, by using the opposing barbs on the suture surface to embed in the tissues after the surgeon precisely places the suture within the tissues. Barbed suture lifting is a minimally invasive surgical technique for facial rejuvenation

While the formation of barbs in the MINT™ reduces the tensile strength relative to non-barbed suture material of the same size, tying knots in non-barbed suture materials also reduce their effective strength. For this reason, the strength of the MINT™ can be compared with USP knot strength of nonbarbed sutures and the USP size of MINT™ is 1 while its tensile strength is equivalent to that of USP 2-0, as demonstrated under the original 510(k) for the MINT™ device (K130191).

The MINT™ Product Family includes models which are supplied with needles. For those models supplied with a needle, designated as "Lifting Thread Combined with needle" in the MINT™ Product Family instructions for use, the needle is used to make the insertion point and for threading of the suture in the patient's dermis.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

cheek subcutaneous fat layer and SMAS layer, mid-face

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

A prospective clinical study was conducted to evaluate safety and effectiveness of the MINT™ Product Family to support mid-face suspension surgery to fixate the cheek sub dermis in an elevated position. The aim of this study was to evaluate the surgical outcomes associated with using MINT™ for improving nasolabial folds.

In this study, 62 male and female subjects were assessed pretreatment and compared to 4, 8, 12, and 24 weeks following treatment using the previously validated and published 5-grade Wrinkle Severity Rating Scale (WSRS) score and rating by independent, blinded assessors. The correction of nasolabial folds using MINT™ was evaluated using blinded evaluator Global Aesthetic Improvement Scale (GAIS) ratings.

The primary effectiveness evaluation was carried out at 12 weeks after surgery by comparing the photos of nasolabial folds of the patients in the study group by blinded evaluators. Twenty-four weeks were set for final safety and effectiveness evaluation period. The primary effectiveness evaluation was carried out at 12 weeks after surgery by comparing the photos of the patients in the study group.

The ratio of subjects in the study group who showed wrinkle improvement (WSRS: below -1 point) by independent evaluation at 12 weeks after the application of test device, the primary effectiveness endpoint, was analyzed. The results showed 59 subjects (96.72%) in FA set showed improvement (WSRS: below -1 point) and the lowest confidence level of 20.95% was greater than 0, indicating superiority.

The results of secondary effectiveness evaluation showed the ratio of the subjects in FA who showed improvement (WSRS: below -1 point) by the evaluation of independent evaluators after the application of test device was 100% (61 subjects) at week 4, 96.72% (59 subjects) at week 8 and 90.16% (55 subjects) at week 24. The ratio of the subjects in FA who showed improvement (WSRS: below -1 point) by the evaluation of testers was 100% (61 subjects) at week 4, 8, 12 and 24. This tendency was represented in the results of an analysis of PP test.

When comparing the WSRS evaluated by independent evaluators at 4, 8, 12 and 24 weeks after the application of test device with baseline of FA set was 3.30 ± 0.45 points; the difference in the mean of WSRS in comparison with baseline at each point was -1.56 ± 0.43 points at week 4, 1.41 ± 0.48 points at week 8, -1.23 ± 0.41 points at week 12, and -1.20 ± 0.45 points at week 24, indicating a decrease over time and statistically significant difference in comparison with baseline at all points of time (p

§ 878.4840 Absorbable polydioxanone surgical suture.

(a)
Identification. An absorbable polydioxanone surgical suture is an absorbable, flexible, sterile, monofilament thread prepared from polyester polymer poly (p-dioxanone) and is intended for use in soft tissue approximation, including pediatric cardiovascular tissue where growth is expected to occur, and ophthalmic surgery. It may be coated or uncoated, undyed or dyed, and with or without a standard needle attached.(b)
Classification. Class II (special controls). The special control for the device is FDA's “Class II Special Controls Guidance Document: Surgical Sutures; Guidance for Industry and FDA.” See § 878.1(e) for the availability of this guidance document.

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Image /page/0/Picture/0 description: The image contains the logos of the Department of Health & Human Services and the Food and Drug Administration (FDA). The Department of Health & Human Services logo is on the left, and the FDA logo is on the right. The FDA logo includes the letters "FDA" in a blue square, followed by the words "U.S. FOOD & DRUG ADMINISTRATION" in blue text.

September 9, 2020

Hans Biomed Corporation % Michael Dun Senior Consultant, Quality and Regulatory Affair Emergo Global Consulting, LLC 2500 Bee Cave Road Building 1, Suite 300 Austin, Texas 78746

Re: K192423

Trade/Device Name: MINT Product Family Regulation Number: 21 CFR 878.4840 Regulation Name: Absorbable Polydioxanone Surgical Suture Regulatory Class: Class II Product Code: NEW Dated: June 18, 2020 Received: August 10, 2020

Dear Michael Dun:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's

1

requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Cindy Chowdhury, Ph.D., M.B.A. Acting Assistant Director DHT4B: Division of Infection Control and Plastic Surgery Devices OHT4: Office of Surgical and Infection Control Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K192423

Device Name MINTTM

Indications for Use (Describe)

MINT™ is indicated for use in mid-face suspension surgery to temporarily fixate the cheek subcutaneous fat layer and SMAS layer in an elevated position for the treatment of moderate to severe nasolabial folds.

Type of Use (Select one or both, as applicable)
-------------------------------------------------

X Prescription Use (Part 21 CFR 801 Subpart D)

| | Over-The-Counter Use (21 CFR 801 Subpart C)

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510(k) Summary

MINT™ Product Family

1. Submission Sponsor

Hans Biomed Corporation

7, Jeongui-ro 8-gil, Songpa-gu

Seoul, 05836

Republic of Korea

Contact: Lucy Choi

Title: General Manager

2. Submission Correspondent

Emergo Global Consulting, LLC

2500 Bee Cave Road

Building 1, Suite 300

Austin, TX 78746

Office Phone: (512) 327.9997

Contact: Michael Dun

Title: Senior Consultant, Quality and Regulatory Affairs

3. Date Prepared

9 September2020

4. Device Identification

Trade/Proprietary Name:MINT™ Product Family
Common/Usual Name:Absorbable surgical suture
Classification Name:Absorbable polydioxanone surgical suture
Regulation Number:21 CFR §878.4840

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Product Code:NEW
Device Class:Class II
Classification Panel:General & Plastic Surgery

5. Legally Marketed Predicate Device(s)

The primary predicate is the Silhouette InstaLift™ device cleared under K163676 by Silhouette Lift, Inc. The reference device is the original MINT™ device cleared under K130191 by Hans Biomed Corporation. Neither the predicate nor reference devices have been subject to a design-related recall.

6. Indication for Use Statement

MINT™ is indicated for use in mid-face suspension surgery to temporarily fixate the cheek subcutaneous fat layer and SMAS layer in an elevated position for the treatment of moderate to severe nasolabial folds.

7. Device Description

The MINT™ device is a sterile synthetic absorbable surgical suture comprised of polydioxanone, (GHoOJ)n. Polydioxanone has been found to be nonantigenic and to elicit only a slight tissue reaction during absorption. The pigment of the violet dye is D&C Violet No.2 (21CFR §74.3602). MINT™ is available in a range of gauge sizes and lengths.

Each suture has bi-directional barbs along the long axis of the suture monofilament. The MINT™ Synthetic Absorbable PDO suture approximates tissues, without the need to tie surgical knots, by using the opposing barbs on the suture surface to embed in the tissues after the surgeon precisely places the suture within the tissues. Barbed suture lifting is a minimally invasive surgical technique for facial rejuvenation

While the formation of barbs in the MINT™ reduces the tensile strength relative to non-barbed suture material of the same size, tying knots in non-barbed suture materials also reduce their effective strength. For this reason, the strength of the MINT™ can be compared with USP knot strength of nonbarbed sutures and the USP size of MINT™ is 1 while its tensile strength is equivalent to that of USP 2-0, as demonstrated under the original 510(k) for the MINT™ device (K130191).

The MINT™ Product Family includes models which are supplied with needles. For those models supplied with a needle, designated as "Lifting Thread Combined with needle" in the MINT™ Product Family instructions for use, the needle is used to make the insertion point and for threading of the suture in the patient's dermis.

8. Substantial Equivalence Discussion

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The MINT™ Product Family is currently indicated for use in soft tissue approximation where the use of absorbable sutures is appropriate (K130191). The purpose of this submission is to obtain clearance of a new indication for the MINT™ Product Family for use in "lifting" procedures which includes variants supplied with needles. Due to the difference in intended use, the cleared MINT™ device family (K130191) is presented as a reference device in this submission while the cleared Silhouette InstaLift™ device family (K163676) is presented as the predicate as it has an identical intended use to that for the subject MINT™ device and includes variants supplied with identical composition to the needles supplied with certain variants of the subject device. Additionally, while the predicate device is comprised of a different material (poly glycolide/L-lactide) and has a different number of barbs to that used in the subject device (polydioxanone (PDO)) questions of biocompatibility and clinical effectiveness are identical. Therefore, different questions of safety and effectiveness are not raised with the subject device in relation to these difference in technological characteristics.

While there are differences in the indications for use between the subject MINT™ Product Family and the predicate Silhouette InstaLift™ device family (K163676), these differences do not constitute differences in intended use or raise different questions of safety and effectiveness. Both devices are absorbable surgical sutures for use in soft tissue indicated for mid-face suspensions surgery to temporarily fixate the cheek in an elevated position. Both devices achieve nasolabial fold depth reduction as it is a clinical outcome of mid-face suspension surgery, as reported in the following published literature, copies of which accompany this submission:

  1. Noone, R.B. (2006) Suture Suspension Malarplasty with SMAS Plication and Modified SMASectomy: A Simplified Approach to Midface Lifting. Plast. Reconstr. Surg. 117: 792.

  2. Benito, J., et al. (2011) Facial Rejuvination and Improvement of Malar Projection Using Sutures with Absorbable Cones: Surgical Technique and Case Series. Aesth. Plast. Surg. 35: 248-253.

  3. Paul, M. D. et al. (2006) The Evolution of the Midface Lift in Aesthetic Plastic Surgery. Plast. Reconstr. Surg. 117: 1809-1827.

The following table compares the MINT™ Product Family to the predicate device with respect to indications for use, principles of operation, technological characteristics, materials, and performance testing. The subject device does not raise any new issues of safety or effectiveness based on the similarities to the predicate device and shown by clinical and other scientific data presented in this submission.

ManufacturerSubmission DevicePredicate DeviceSignificant Differences
Hans Biomed CorporationSILHOUETTE LIFT, INC
Trade NameMINT™Silhouette InstaLift™
ManufacturerSubmission DevicePredicate DeviceSignificant Differences
Hans Biomed CorporationSILHOUETTE LIFT, INC
Trade NameMINT™Silhouette InstaLift™
510(k)
NumberK192423K163676Not applicable
Product CodeNEWGAMDifferent;
The difference in Product
Code does not raise new
questions of safety and
effectiveness. Both product
codes cover absorbable
surgical sutures.
Regulation
Number21 CFR 878.484021 CFR 878.4493Different;
The difference in
Regulation Number does
not raise new questions of
safety and effectiveness.
Both regulations cover
absorbable, sterile flexible
surgical sutures that are
intended for use in soft
tissue approximation,
coated or uncoated, and
with or without a standard
needle attached.
Regulation
NameSuture, Surgical,
Absorbable, PolydioxanoneSuture, Absorbable,
Synthetic, Polyglycolic AcidDifferent;
The difference in
Regulation Name does not
raise new questions of
safety and effectiveness.
Both regulations cover
absorbable, sterile flexible
surgical sutures that are
intended for use in soft
tissue approximation,
coated or uncoated, and
with or without a standard
needle attached.
ManufacturerSubmission DevicePredicate DeviceSignificant Differences
Hans Biomed CorporationSILHOUETTE LIFT, INC
Trade NameMINT™Silhouette InstaLift™
needle attached.
Intended UseAbsorbable surgical sutures
for use in soft tissueAbsorbable surgical sutures
for use in soft tissueIdentical
Indication for
useMINT™ is indicated for use
in mid-face suspension
surgery to temporarily
fixate the cheek
subcutaneous fat layer and
SMAS layer in an elevated
position for the treatment
of moderate to severe
nasolabial folds.The Silhouette InstaLift™
device is indicated for use in
mid-face suspension surgery
to temporarily fixate the
cheek subdermis in an
elevated position.Similar. While there are
differences, these do not
constitute differences in
intended use or raise
different questions of
safety and effectiveness.
Both devices are
absorbable surgical sutures
for use in soft tissue
indicated for mid-face
suspension surgery to
temporarily fixate the
cheek in an elevated
position. Both devices
achieve nasolabial fold
depth reduction as it is a
clinical outcome of mid-
face suspension surgery, as
reported in published
literature referenced in this
510(k).
Raw MaterialPolydioxanone suture
Stainless steel (SUS 304)
needlePoly glycolide/L-lactide
suture
Stainless steel (SUS 304)
needleDifferent; While there are
differences in suture
material to the predicate
device K163676, these do
not raise new questions of
safety and effectiveness.
Biocompatibility data on file
for the reference MINT™
device family K130191
demonstrate the device's
ManufacturerSubmission DevicePredicate DeviceSignificant Differences
Hans Biomed CorporationSILHOUETTE LIFT, INC
Trade NameMINT™Silhouette InstaLift™biocompatibility while
clinical data presented in
this submission also
demonstrate equivalent
safety and performance.
Suture
CharacteristicSynthetic Absorbable
MonofilamentSynthetic Absorbable
MonofilamentIdentical
Technique of
DeploymentNeedle-based deploymentNeedle-based deploymentIdentical;
Both include variants
supplied with needles.
Technological
CharacteristicBi-directional barbs along
the long axis of the suture
monofilamentBi-directional barbs along the
long axis of the suture
monofilamentIdentical
SterilizationEthylene OxideEthylene OxideIdentical
Size (USP)1-01-0Identical
AbsorbableAbsorbableAbsorbableIdentical
Patient
contactImplantImplantIdentical
Duration of
contactOver 30 DaysOver 30 DaysIdentical
Number of
barbs per
linear length
of suture20 barbs per 10cm in all
sutures.8 barbs in 30cm sutures.
12 barbs in 27.5cm sutures.
16 barbs in 26.8cm sutures.Different; While there are
differences in the number
of barbs to the predicate
device K163676, these
devices are substantially
equivalent as no new
questions of safety and
effectiveness are raised, as
demonstrated by barb
holding strength testing
and clinical data presented
in this submission.
ManufacturerSubmission DevicePredicate DeviceSignificant Differences
Hans Biomed CorporationSILHOUETTE LIFT, INC
Trade NameMINTTMSilhouette InstaLiftTM
Barb Holding Strength
(Average ± Standard Deviation)$20.94 ± 3.93 N$$9.90 ± 0.93 N$Different; While there are differences in the average barb holding strength to predicate device K163676, the differences do not raise new questions of safety and effectiveness as the average barb holding strength for the subject MINTTM device is superior to that of the predicate. Clinical data presented in this submission also demonstrate equivalent safety and performance.
Barb shapeCog shapeCog shapeIdentical
Barb size0.601mm0.601mmIdentical
Barb directionA section and B section is opposite directionA section and B section is opposite directionIdentical
Pattern of the barbsBi-directional barbs along the long axis of the sutureBi-directional barbs along the long axis of the sutureIdentical
Suture diameterCompliant with USP requirementsCompliant with USP requirementsIdentical
Suture tensile strengthCompliant with USP requirementsCompliant with USP requirementsIdentical
Suture-Needle attachmentCompliant with USP requirementsCompliant with USP requirementsIdentical

Table 5A - Comparison of Characteristics

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9. Non-Clinical Performance Data

Additional testing was conducted and relevant scientific data collated for this 510(k). Previous tests performed on the MINT™ reference device (K130191) included those for overall design, sterilization, biocompatibility, and the physical and performance testing as described in the guidance entitled Class II Special Controls Guidance Document: Surgical Sutures, confirming that the design output meets the

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design inputs and specifications for the sutures. These data also apply to the subject device, in all aspects except the expanded indications for use and provision of variants with needles.

The non-clinical performance testing performed on the subject device MINT™ Product Family variants including needles included physical and performance and real-time stability testing was focused on generating scientific data to support the inclusion of the needles in addition to generating scientific data to support the expansion of suture variants in order to demonstrate compliance with USP Suture diameter, USP Suture-Needle attachment, and USP Suture tensile strength requirements.

Additional comparative barb holding strength testing was performed to demonstrate that the MINT™ Product Family displays superior barb holding strength to that for the Silhouette InstaLift™ predicate device (K163676).

The results of non-clinical performance testing demonstrate substantial equivalency between the MINT™ Product Family (K192423) and the predicate Silhouette InstaLift™ device (K163676) as they both comply with all the requirements of USP Suture diameter, USP Suture-Needle attachment, and USP Suture tensile strength, and that the MINT™ Product Family displays superior barb holding strength to that for the Silhouette InstaLift™.

10. Animal Performance Data

In vivo studies in animal models to demonstrate absorption and mechanical strength of the subject device were performed.

The in vivo absorption study was completed on 30 rats prepared and anesthetized in accordance with the procedure and was performed on Monosorb, identical to the sutures used in the MINT™ Product Family. The results of this study indicated in vivo absorption of the sutures occurs between 180°220 days post-implantation.

The in vivo mechanical strength study was completed on rats prepared and anesthetized in accordance with the procedure and performed on MINT™ barbed suture. The results of this study indicated that tensile strength retention of MINT™ (USP 1) was 44.5% at 6 weeks and was unable to be measured at 10 and 12 weeks post-implantation due to severe degradation. Based on the results of this study, the breaking strength retention of MINT™ is considered to be approximately 50% at 6 weeks.

11. Clinical Performance Data

A prospective clinical study was conducted to evaluate safety and effectiveness of the MINT™ Product Family to support mid-face suspension surgery to fixate the cheek sub dermis in an elevated position. The aim of this study was to evaluate the surgical outcomes associated with using MINT™ for improving nasolabial folds.

11

In this study, 62 male and female subjects were assessed pretreatment and compared to 4, 8, 12, and 24 weeks following treatment using the previously validated and published 5-grade Wrinkle Severity Rating Scale (WSRS) score and rating by independent, blinded assessors. The correction of nasolabial folds using MINT™ was evaluated using blinded evaluator Global Aesthetic Improvement Scale (GAIS) ratings.

The primary effectiveness evaluation was carried out at 12 weeks after surgery by comparing the photos of nasolabial folds of the patients in the study group by blinded evaluators. Twenty-four weeks were set for final safety and effectiveness evaluation period. The primary effectiveness evaluation was carried out at 12 weeks after surgery by comparing the photos of the patients in the study group.

The ratio of subjects in the study group who showed wrinkle improvement (WSRS: below -1 point) by independent evaluation at 12 weeks after the application of test device, the primary effectiveness endpoint, was analyzed. The results showed 59 subjects (96.72%) in FA set showed improvement (WSRS: below -1 point) and the lowest confidence level of 20.95% was greater than 0, indicating superiority.

The results of secondary effectiveness evaluation showed the ratio of the subjects in FA who showed improvement (WSRS: below -1 point) by the evaluation of independent evaluators after the application of test device was 100% (61 subjects) at week 4, 96.72% (59 subjects) at week 8 and 90.16% (55 subjects) at week 24. The ratio of the subjects in FA who showed improvement (WSRS: below -1 point) by the evaluation of testers was 100% (61 subjects) at week 4, 8, 12 and 24. This tendency was represented in the results of an analysis of PP test.

When comparing the WSRS evaluated by independent evaluators at 4, 8, 12 and 24 weeks after the application of test device with baseline of FA set was 3.30 ± 0.45 points; the difference in the mean of WSRS in comparison with baseline at each point was -1.56 ± 0.43 points at week 4, 1.41 ± 0.48 points at week 8, -1.23 ± 0.41 points at week 12, and -1.20 ± 0.45 points at week 24, indicating a decrease over time and statistically significant difference in comparison with baseline at all points of time (p