Abstract

Objectives: 1- Introduce the novel innovative technique of mixing calcium and non cross-linked hyaluronic acid. 2- Explain the tailored injection technique according to each patient 3- Manage skin sagging with less complications. Introduction: Fillers based on crosslinked hyaluronic acid (HA) are becoming increasingly important in the field of aesthetic medicine. Calcium hydroxylapatite (CaHA) is a fully biodegradable filler, dissolved in a gel that have been on the market for a very long time. After understanding the market’s direction due to the increased number of patients aiming for a more natural look, and a longer duration of the improved skin quality and glow, I tried this mix to create a hyperdiluted form of calcium biostimulator, by diluting it with non-cross linked HA instead of saline. Materials / method: A total of 30 patients were included, all females with age ranging between 35 and 60 years. Mixing of the CaHA (0.8 or 1.5 ml) with one ampoule of non cross-linked HA is done using a connector for one minute until mixed well (at least 30 times). Then marking the landmarks of the face of the patient then marking the injection points. Injection is done using a 25 or 22 gauge cannula after puncturing the skin with a needle tip, to inject in the subcutaneous plane using slow retrograde together with microdroplet injection technique. Results: After 1 month, patients were assessed in follow up visit. Improvement in skin laxity, tone and fine lines was noticed. Also face lifting was noted, proven by improvement in the nasolabial folds, and elevation of the level of the outer canthus of the eyes and corners of the mouth. Lateral eye brows elevation was also achieved in patients injected in the temporal area and the adjacent hairline area. Patients felt improvement in skin hydration, fine wrinkles, looseness of the skin and whole face rejuvenation, resulting in high satisfaction rate. Conclusion: This is by far the first study to document the use of this novel combination in skin rejuvenation. In conclusion, this new combination of CaHA and non crosslinked HA showed great results in improvement of skin quality, lifting and hydration and is considered a safe and effective option in treatment of sagging and facial wrinkles.. This mixture provides the fibroblasts with the amino acids, which are considered to be the raw material to synthesize collagen after biostimulation with the CaHA. Non cross-linked HA is also safer, more economic, and with less possibility of migration.