(8) Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening

Thursday, September 15, 2022

1:30 PM – 3:00 PM CDT

Presenting Author(s)

Steven Halepas, DMD, MD

Resident
Columbia University Medical Center/New York Presbyterian Hospital
New York, New York, United States

Co-Author(s)

CC

Cameron Christiansen, DMD

Resident
Nassau Medical Center
Farmington, Connecticut, United States
Elie M. Ferneini, DMD, MD

Medical Director
University of Connecticut School of Dental Medicine
Cheshire, Connecticut, United States

Disclosure(s):

Steven Halepas, DMD, MD: No financial relationships to disclose

Cameron Christiansen, DMD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Elie M. Ferneini, DMD, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Abstract: Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening

Introduction
Calcium hydroxylapatite (CaHA) has been used as a soft tissue filler for many years. Since Radiesse® (CaHA) was approved for use in December 2006, it has been used to provide volume to correct cosmetic defects. One of the advantages of using a calcium hydroxylapatite filler is the neocollagenesis that occurs in addition to the increased volume provided by the viscosity of the material. This allows for not only beneficial short term cosmetic effects, but also sustainable long term effects with the stimulation and formation of new collagen. Recently, a new technique using Radiesse® has been developed to improve the skin laxity caused by decreased collagen formation with aging. Radiesse® typically needs to be placed deep in the dermis due to its high viscosity, but clinicians have found that if Radiesse® is diluted with a mixture of lidocaine and/or saline, the viscosity is reduced, but the neocollagenesis is sustained allowing for tightening of the skin. The reduced viscosity allows the oral and maxillofacial surgeon to place the filler more superficial and reduce the appearance of undesirable wrinkles and improve dermal remodeling.

Methods
The purpose of this study was to assess the predictability and safety of using diluted Radiesse® to improve skin laxity in the face, neck, and décolletage areas while reviewing the proper techniques for a successful procedure. A 2-year retrospective assessment of clinical outcomes and adverse events was performed in patients who had diluted Radiesse® placed between 1/1/2020 - 12/31/2021 as outpatient procedures.

Results
A total of 32 patients (31 female and 1 male), aged 32-65 years old, underwent treatment with diluted Radiesse® in different locations including the face, neck, or décolletage area between 1/1/2020 and 12/31/2021. All patients were satisfied and showed improvement in skin laxity. None of the patients reported major complications from the procedure. Minor complications included bruising, edema, swelling, mild pain, and erythema.

Conclusion
Using diluted Radiesse® is a safe and effective technique to improve skin laxity and should be recommended to patients. Its effect is beneficial in neocollagenesis and dermal remodeling. Diluted Radiesse® can be placed in the face, the neck, and the décolletage areas with success. Other areas of interest include: arms, abdomen, buttocks. Further clinical trials are necessary to provide surgeons with the best evidence based use of this newer technique.

References
Goldie K, Peeters W, Alghoul M, et al. Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening [published correction appears in Dermatol Surg. 2019 Feb;45(2):327]. Dermatol Surg. 2018;44 Suppl 1:S32-S41. doi:10.1097/DSS.0000000000001685
de Almeida AT, Figueredo V, da Cunha ALG, et al. Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent. Plast Reconstr Surg Glob Open. 2019;7(3):e2160. Published 2019 Mar 14. doi:10.1097/GOX.0000000000002160