Evaluation of Injectable CaHA for the Treatment of Mid-face Volume Loss

Background: Calcium hydroxylapatite (CaHA) is presently approved for the correction of moderate to severe facial wrinkles and folds and signs of HIV-associated facial lipoatrophy.

Objective: This 6-month pilot study was designed to evaluate clinical efficacy and patient satisfaction of CaHA to treat mid-face volume loss.

Methods: Nineteen patients received initial malar injections of CaHA. At 1, 3, and 6 months, patients were evaluated for mid-face volume loss, satisfaction, and adverse events. Touch ups were administered at 3 months, with enhancement injections permitted at 6 months.

Results: Average treatment volumes were 1.3 mL CaHA gel per side. At 1, 3, and 6 months, 88%, 74%, and 75% of patients rated themselves "very satisfied/satisfied" and physicians rated 82%, 100%, and 94% of patients as "improved" or greater, respectively. Global Aesthetic Improvement Scale (GAIS) scores were similar. At 6 months, 88% of patients were pleased with the outcome and 81% would recommend CaHA cheek augmentation.

Conclusions: Malar augmentation with CaHA gel appears to be a viable nonsurgical alternative for patients with midface volume loss, with good patient satisfaction and excellent tolerability.