{"title":"A Novel Six-Point Supraperiosteum Injection with Calcium Hydroxyapatite for Jawline Refining and Facial Anti-aging in Asian Patients.","authors":"Bing-Qi Wu, Yun-Jhen Lin, Chang-Cheng Chang, Man-Lok Lio, Wei-Chun Chang, Hsiu-Mei Chiang, Yung-Hsueh Huang, Ying-Chuan Hsu","doi":"10.1007/s00266-025-05045-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Supraperiosteal injection by calcium hydroxyapatite (CaHA) fillers is an efficient treatment for facial rejuvenation to achieve bony recontouring, facial augmentation and lifting. However, a safe and efficient injection technique for Asians was not described, and an assessment scale to quantify \"facial anti-aging\" does not exist.</p><p><strong>Methods: </strong>We enrolled 16 Asian women (n = 32) to receive a single session of six-point calcium hydroxyapatite (CaHA, Radiesse® Plus) filler injections between July 1, 2021, and July 1, 2022. The six injection sites included the eyebrow arch, lateral eyebrow, lateral zygoma, piriform fossa, lateral chin, and anteromedial cheek. Efficacy was assessed at weeks 0 (immediately post-treatment), 4, 12, and 24 using a specialized angular and length measurement system, with outcomes further evaluated using an 11-level anti-aging scale.</p><p><strong>Results: </strong>Among the four angular and six linear parameters assessed, statistically significant variations were observed across five time points. Regarding post hoc analyses, the Eyebrow-Tail angle showed a statistically significant change at week 24, increasing by 2.84° (p < 0.001) and corresponding to an anti-aging scale value of 6. This parameter indicated eyebrow lifting. The Tragus-Oral (-10.4 mm, p = 0.004) and Lower Facial Contouring (-9.8 mm, p = 0.044) showed statistically significant reductions and received aging scale ratings of 10 and 9, respectively, at week 24. These two parameters indicated achieving jawline refining. Overall, the final anti-aging scale improved from an average of 50-59, with minimal or ignorable ecchymosis and swelling at week 24.</p><p><strong>Conclusions: </strong>The 6-point calcium hydroxyapatite filler injection achieved facial rejuvenation. After a single session, the injection recontoured the jawline and lifted the eyebrow tail.</p><p><strong>Level of evidence iv: </strong>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 Table of Contents or online Instructions to Authors www.springer.com/00266.</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00266-025-05045-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Supraperiosteal injection by calcium hydroxyapatite (CaHA) fillers is an efficient treatment for facial rejuvenation to achieve bony recontouring, facial augmentation and lifting. However, a safe and efficient injection technique for Asians was not described, and an assessment scale to quantify "facial anti-aging" does not exist.
Methods: We enrolled 16 Asian women (n = 32) to receive a single session of six-point calcium hydroxyapatite (CaHA, Radiesse® Plus) filler injections between July 1, 2021, and July 1, 2022. The six injection sites included the eyebrow arch, lateral eyebrow, lateral zygoma, piriform fossa, lateral chin, and anteromedial cheek. Efficacy was assessed at weeks 0 (immediately post-treatment), 4, 12, and 24 using a specialized angular and length measurement system, with outcomes further evaluated using an 11-level anti-aging scale.
Results: Among the four angular and six linear parameters assessed, statistically significant variations were observed across five time points. Regarding post hoc analyses, the Eyebrow-Tail angle showed a statistically significant change at week 24, increasing by 2.84° (p < 0.001) and corresponding to an anti-aging scale value of 6. This parameter indicated eyebrow lifting. The Tragus-Oral (-10.4 mm, p = 0.004) and Lower Facial Contouring (-9.8 mm, p = 0.044) showed statistically significant reductions and received aging scale ratings of 10 and 9, respectively, at week 24. These two parameters indicated achieving jawline refining. Overall, the final anti-aging scale improved from an average of 50-59, with minimal or ignorable ecchymosis and swelling at week 24.
Conclusions: The 6-point calcium hydroxyapatite filler injection achieved facial rejuvenation. After a single session, the injection recontoured the jawline and lifted the eyebrow tail.
Level of evidence iv: 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 Table of Contents or online Instructions to Authors www.springer.com/00266.
背景：骨膜上注射羟基磷灰石钙（CaHA）填充物是一种有效的面部年轻化治疗方法，可实现骨重塑、面部增大和提升。然而，目前还没有针对亚洲人的安全有效的注射技术，也没有量化“面部抗衰老”的评估量表。方法：我们招募了16名亚洲女性（n = 32），在2021年7月1日至2022年7月1日期间接受了单次点式羟基磷灰石钙（CaHA, Radiesse®Plus）填充剂注射。六个注射部位包括眉弓、外侧眉、外侧颧骨、梨状窝、外侧下巴和前内侧脸颊。在第0周（治疗后立即）、第4周、第12周和第24周使用专门的角度和长度测量系统评估疗效，并使用11级抗衰老量表进一步评估结果。结果：在评估的四个角度参数和六个线性参数中，在五个时间点观察到统计学上显著的变化。在事后分析中，在第24周，眉毛-尾部角度显示有统计学意义的变化，增加了2.84°（p < 0.001），对应的抗衰老量表值为6。这个参数表示提眉。在第24周时，耳屏-口腔（-10.4 mm, p = 0.004）和下面部轮廓（-9.8 mm, p = 0.044）显示有统计学意义的减少，老化评分分别为10分和9分。这两个参数表明实现了下颌轮廓的细化。总体而言，最终抗衰老评分从平均50-59分改善，第24周出现最小或可忽略的瘀斑和肿胀。结论：6点羟基磷灰石钙填充剂可实现面部年轻化。单次注射后，下巴轮廓重塑，眉尾翘起。证据等级iv：本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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