Abstract Background Facial aging is a multifactorial process characterized by soft tissue atrophy, skeletal remodeling, and degradation of dermal extracellular matrix components such as collagen and elastin. Injectable biostimulators have gained popularity in recent years for their efficacy in reinforcing the structural foundation of the face by stimulating the body’s natural regenerative processes. Objectives This study aims to assess the author’s multi-depth injection technique with hyperdilute calcium hydroxylapatite (CaHA-CMC; Radiesse®, Merz Aesthetics, Raleigh, NC) for multilayered collagen biostimulation to address laxity, jowling, and skin aging-related changes. Methods This study reviewed the charts of 22 patients who underwent two treatment sessions with hyperdilute CaHA-CMC (1:3 ratio) using the author’s technique for targeted rejuvenation of the mid and lower face. At each visit, assessments included the global aesthetic improvement scale (GAIS), subject satisfaction, and rankings of aging parameters of the face measured by five-point photonumeric scales. Volumetric changes were objectively measured with three-dimensional imaging analysis via Quantificare’s 3D Track® software. Results Quantitative analysis at D150 revealed a significant improvement in cheek volume (P=0.0012) and significant reductions in jowl volume, nasolabial fold depth, and marionette line depth (P0.0001, P0.0001, P=0.0019, respectively). GAIS evaluations from the treating physician, a blinded evaluator, and subjects demonstrated progressive improvement peaking at D150. Conclusions The results of this study support the safety and efficacy of the author’s novel technique with hyperdilute CaHA for lower and midface rejuvenation, further enhancing the utility of biostimulators in aesthetic medicine.
Durairaj et al. (Mon,) studied this question.
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