Diluted and Hyperdiluted Calcium Hydroxyapatite For Skin Tightening
Abstract
Biostimulatory fillers, such as calcium hydroxylapatite (CaHA), have been used for more than a decade for facial voluminization and HIV-induced lipoatrophy. Over the last few years, CaHA has also been increasingly utilized to tighten skin and improve skin quality. CaHA is a biodegradable and resorbable filler composed of microspheres suspended in an aqueous carboxymethyl cellulose gel carrier. The biostimulatory nature of CaHA distinguishes it from other fillers: while the carrier provides initial volume replacement, the particles induce a delayed fibroblast and histiocyte response leading to increased collagen and elastin formation, and ultimately dermal remodelling.
CaHA reconstitutions can be categorized based on ratios: none/undiluted, dilute (1:1), and hyperdiluted (≥1:2). In hyperdiluted forms, CaHA causes biostimulation without voluminization. Overall, this leads to skin tightening and improvement of various skin parameters, such as elasticity, firmness, superficial wrinkles, and overall appearance. The use of diluted and hyperdiluted CaHA for skin tightening is a relatively new technique growing in popularity. It can be used in various areas of the body such as the upper arms, abdomen, and thighs. Hyperdiluted CaHA has also been used to treat cellulite and striae.
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