Hand Rejuvenation with Customizable Hybrid Fillers: Premixed Calcium Hydroxyapatite and Hyaluronic Acid

• Published in: Aesthetic plastic surgery Vol. 48; no. 15; pp. 2887 - 2894
• Main Authors: Faria, Gladstone Eustaquio de Lima, Fakih-Gomez, Nabil, Tartare, Adriane, Zattar, Luciana, Machado, Ana Carolina Henriques Ribeiro, Felice, Fernando, Kadouch, Jonathan, Muñoz-Gonzalez, Cristina, Boggio, Ricardo Frota
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2024; Springer Nature B.V
• Subjects: Hyaluronic acid; Hydroxyapatite; Medicine; Medicine & Public Health; Original Articles; Otorhinolaryngology; Plastic Surgery; Ultrasonic imaging; Hybrid; CaHA; Hand rejuvenation; Filler
• ISSN: 0364-216X; 1432-5241; 1432-5241
• DOI: 10.1007/s00266-024-04145-4

Introduction Hand aging is a prevalent concern characterized by the atrophy of local soft tissues and increased visibility of vessels and tendons. Hyaluronic acid (HA) and calcium hydroxyapatite (CaHA) are well-established treatments for addressing this issue. While hybrid filler containing HA and CaHA has been proposed for facial rejuvenation, studies investigating its efficacy for hand rejuvenation are lacking. Objective This study aims to assess the safety and efficacy of a premixed hybrid filler containing calcium hydroxyapatite (CaHA) and hyaluronic acid (HA) for hand rejuvenation. Methods A prospective, double-blind, controlled trial was conducted. The control arm (CA) received conventional subdermal treatment with CaHA at a 1:1 dilution. The intervention arm (IA) underwent hybrid treatment, consisting of CaHA at a 1:1 dilution combined with 1 ml of low-density HA. Evaluation was performed subjectively using the Global Aesthetic Improvement Scale (GAIS) and the Manchester Hand Grading System (MHGS), and objectively using cutometry, corneometry, and ultrasound. Results Both the CA and the IA exhibited high rates of patient satisfaction and satisfaction as assessed by blinded evaluators. Although numerical superiority was observed in the IA, no statistical difference was found between the two groups. Significant improvements in hydration, elasticity, and skin thickness were observed in both arms, with no discernible difference between them. Greater ultrasound echogenicity was noted in the IA, which, as indicated by existing literature, may suggest enhanced biostimulation. No adverse effects were reported in either arm. Conclusion Premixed filler containing HA and CaHA for hand rejuvenation appears to be a safe and effective approach. Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .