Clinical, Cosmetic and Investigational Dermatology (Nov 2024)
Treatment of Mid-Face Aging with Calcium Hydroxylapatite: Focus on Retaining Ligament Support
Abstract
Mauricio Sato,1 Mariana Muniz,2 Luis Ricardo Coelho Ferreira3 1IDEL Institute, Dermatology Department, Curitiba, Brazil; 2Mariana Muniz Dermatologia, Dermatology Department, São Paulo, Brazil; 3Federal University of Parana, Radiology Department, Curitiba, BrazilCorrespondence: Mauricio Sato, IDEL Institute, Dermatology Department, Alameda Getúlio Vargas 4474, Curitiba, PR, 80240-041, Brazil, Tel +5541 99977-8475; +55413026-0778, Email [email protected]: The mid-face has been rendered as the cornerstone of facial aesthetic improvement, since treating the mid-face has also beneficial effects on neighboring esthetic units and therefore should be one of the first areas to be assessed. Retaining ligaments (RL) bind soft tissue layers of the face to the underlying facial skeleton. It remains controversial whether RL suffers laxity with aging or if changes in 42 bone and other structures where ligaments are inserted lead to altered mechanical function of the latter. Enhancement of the supportive effect of the ligaments could help restore the soft tissues to their original anatomical positions and achieve a lifting effect. While injectable hyaluronic acid implants have been used to improve ligament support, calcium hydroxylapatite has one of the highest viscoelasticities when compared with other dermal fillers and can induce collagen synthesis, which could provide long-term laxity correction. In this preliminary report of a case series, our goal was to describe the use of calcium hydroxylapatite in different dilutions and combinations for different aging profiles to treat the midface as an alternative for hyaluronic acid injections and to describe the ultrasonographic behavior in the long run.Keywords: rejuvenation, retaining ligaments, calcium hydroxylapatite, hyaluronic acid, soft tissue repositioning, aging pattern
