Improvement of Facial Skin Laxity by a Combined Technique With Hyaluronic Acid and Calcium Hydroxylapatite Fillers: A Clinical and Ultrasonography Analysis

Bravo, Bruna Felix; Penedo, Laís Bezerra de Menezes; Carvalho, Raquel de Melo; Miot, Hélio Amante; Elias, Mariana Calomeni

doi:10.36849/jdd.6333

Cited by 6 publications

(6 citation statements)

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“…According to the experience sharing of experts, a dilution ratio of 1:2 was considered optimal for normal skin, 1:4 for thin skin, and 1:6 for atrophic skin. 9,11 Bravo and colleagues 15 reported an 11% increase in dermal thickness at the end of the fourth month due to the combination of 1:1 diluted CaHA and hyaluronic acid in facial skin laxity. Fabi and colleagues 16 drew attention to the wrinkles in the décolleté area, which significantly improved after a single injection of CaHA (1:2 dilution).…”

Section: Discussionmentioning

confidence: 99%

The Comparative Dermal Stimulation Potential of Constant-Volume and Constant-Amount Diluted Calcium Hydroxylapatite Injections Versus the Concentrated Form

et al. 2023

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INTRODUCTION Biostimulation properties of diluted and hyperdiluted calcium hydroxylapatite (CaHA) injections have become increasingly popular. However, the existing data are insufficient to certify a particular dose–response pattern. OBJECTIVE To assess and compare the dermal stimulation potentials of different concentrations of CaHA injections. MATERIALS AND METHODS Two independent experiments (Experiment-1: constant injection volume vs Experiment-2: constant CaHA amount) included 4 study groups each, and these experimental groups were placed consecutively on the abdominal skin of a juvenile Yorkshire pig. Histopathological and immunohistochemical stainings were performed on punch biopsy materials collected 4 months after the injection day. RESULTS The fibroblast count significantly decreased upon dilution from 1:3 to 1:19 in experiment 1 (p = .000) but still higher than the control group. In experiment 1, the collagen density of the concentrated form was more elevated than the 1:19 dilution and the negative control groups (p = .034 and .000, respectively) but similar to the 1:3 dilution (p = .123). No significant difference was observed between the groups regarding collagen density with a standard amount of CaHA (0.2 mL, 30%) (p > .05). CONCLUSION Despite the efficacy being more pronounced till 1:3 dilution, hyperdiluted CaHA at any dilution ratio up to 1:19 can provide a higher fibroblast count than the negative control group.

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Section: Discussionmentioning

confidence: 99%

The Comparative Dermal Stimulation Potential of Constant-Volume and Constant-Amount Diluted Calcium Hydroxylapatite Injections Versus the Concentrated Form

et al. 2023

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“… 31 , 32 Concerning facial aesthetic rejuvenation, a significant increase in dermal thickness has been previously demonstrated with a combination technique comprising both HA- and CaHA-based fillers. 33 However, considering that rheological properties are altered when CaHA microspheres and cross-linked HA coexist in the same syringe, changes in dermal thickness following treatment with this premixed combination have not yet been investigated, to our knowledge. For that matter, our study demonstrated that a single-session treatment using HArmonyCa, a novel HA and CaHA combination filler, resulted in a significant increase in dermal thickness.…”

Section: Discussionmentioning

confidence: 99%

Dermal Thickness Increase and Aesthetic Improvement with Hybrid Product Combining Hyaluronic Acid and Calcium Hydroxyapatite: A Clinical and Sonographic Analysis

Bravo¹,

Almeida²,

Carvalho³

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Hyaluronic acid filler injections are regarded as the gold standard procedure for facial rejuvenation. Standing as the second most injected cosmetic filler, calcium hydroxyapatite-based fillers are also widely used worldwide. However, to our knowledge, prospective studies assessing patient satisfaction and sonographic changes in dermal thickness after a single session of a hybrid filler combining hyaluronic acid and calcium hydroxyapatite have not been previously published. Methods: This was a single-center, prospective, quasi-experimental study comprising 15 participants between 32 and 63 years of age. Each participant received a single-session treatment based on facial subcutaneous injections of HArmonyCa, a hybrid combination filler comprising hyaluronic acid and calcium hydroxyapatite. This study involved an intrapatient control design and a 120-day follow-up with clinical and sonographic assessment. For this purpose, standardized photographic images, high-frequency ultrasound evaluations, and physician-and patient-oriented overall aesthetic improvement scores were recorded at 0, 30, 90, and 120 following the procedure. Results: According to our findings, 20% of the subjects had an exceptional improvement; 20%, "very improved"; and 60%, "improved." Intrapatient sonographic comparison showed a significant increase in dermal thickness, at 90 and 120 days, only on the side treated (P < 0.001). Conclusion:In our clinical study, a single-session treatment with a hybrid product combining hyaluronic acid and calcium hydroxyapatite resulted in positive cosmetic satisfaction and increased dermal thickness.

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“…8,9 CaHA, effectively restores volume and can improve skin texture due to its biostimulatory effects of increasing collagen type I, elastin, and angiogenesis. [10][11][12][13][14] As such, 1 treatment of inco-botulinumtoxinA, HA, and CaHA can possibly both meet patient satisfaction standards and alleviate the need for follow-up treatments, though further real-world evidence remains lacking.…”

Section: • This Study Presents Patient-reported Outcomes Datamentioning

confidence: 99%

Global facial rejuvenation with one treatment of incobotulinumtoxinA, hyaluronic acid, and calcium hydroxyapatite results in long-term patient-reported satisfaction

Lu,

Lee

2023

International Journal of Women’s Dermatology

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Background: Global facial rejuvenation using injectables (neuromodulators and fillers) has reported patient satisfaction after 2 treatments: an initial and touch-up treatment at 2–4 weeks afterward. In practice, patients typically receive only 1 treatment and do not return for a touch-up treatment within a month. Objective: The purpose of this study was to assess patient-reported satisfaction after only 1 treatment, thus mimicking real-world scenarios. Methods: Patients with facial photoaging (Glogau facial aging scale ≥2) were treated with calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA injections for full facial rejuvenation, with no touch-up treatments. Patients completed the FACE-Q Satisfaction with Facial Appearance survey at baseline and 1- and 3-month post-treatment. The treating physician completed the Global Aesthetic Improvement Scale at 1- and 3-month post-treatment. Results: Twenty-two patients were enrolled in the study, with 1 patient lost to follow-up. There was a significant improvement in mean FACE-Q scores at 1-month (80.1, P = .01) and 3-month (77.9, P = .02) compared to baseline (71.4). Mean Global Aesthetic Improvement Scale scores at 1-month (2.1) and 3-month (2.2) were not statistically significant, indicating sustained improvement at 3 months. The product amount used per patient varied and was not correlated with either score. Limitations included a lack of a control group and follow-up ending at 3 months. Strengths included assessment of patient satisfaction after only 1 treatment, compared to other studies allowing 2 treatments. Limitations: Limitations include a small sample size and lack of a control group. Conclusion: Global full facial rejuvenation using 1 treatment of calcium hydroxyapatite, hyaluronic acid 22.5 mg/mL, and incobotulinumtoxinA provides sustained patient-reported satisfaction at 3 months.

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Improvement of Facial Skin Laxity by a Combined Technique With Hyaluronic Acid and Calcium Hydroxylapatite Fillers: A Clinical and Ultrasonography Analysis

Cited by 6 publications

References 0 publications

The Comparative Dermal Stimulation Potential of Constant-Volume and Constant-Amount Diluted Calcium Hydroxylapatite Injections Versus the Concentrated Form

The Comparative Dermal Stimulation Potential of Constant-Volume and Constant-Amount Diluted Calcium Hydroxylapatite Injections Versus the Concentrated Form

Dermal Thickness Increase and Aesthetic Improvement with Hybrid Product Combining Hyaluronic Acid and Calcium Hydroxyapatite: A Clinical and Sonographic Analysis

Global facial rejuvenation with one treatment of incobotulinumtoxinA, hyaluronic acid, and calcium hydroxyapatite results in long-term patient-reported satisfaction

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