Abstract

Objectives: To discuss the role of calcium hydroxyapatite (CaHA) as a pre-treatment to optimize the anchorage of P(LA/CL) threads, exploring its ability to enhance dermal structure and fibroconnective support, and to analyze the clinical benefits of this approach in facial lifting procedures. Introduction: P(LA/CL) threads, composed of polylactic acid (PLA) and caprolactone, are commonly used for facial lifting. This study evaluates the efficacy of calcium hydroxyapatite (CaHA) as a pre-treatment to improve dermal and subcutaneous structure, enhance fibroconnective tissues, and strengthen interlobular septa for better anchorage of the threads. We hypothesize that CaHA administered 60 days before thread application may result in improved outcomes. Materials / method: Twelve female patients, aged between 38-50 years old, with mild to moderate facial laxity, were enrolled in this prospective study. Each patient received one syringe of CaHA-based biostimulator per hemiface. Ultrasound imaging, photography were performed to assess baseline facial aesthetics, skin structure and thickness. At baseline, six patients received CaHA injections 60 days before the thread application. After 60 days, all 12 patients underwent the thread-lifting procedure. Outcomes were evaluated based on ultrasound results, photography, and patient satisfaction questionnaires. Results: Preliminary data suggest that pre-treatment with CaHA enhanced the dermal matrix and improved anchoring sites for the threads, leading to more effective lifting and contouring. Quantitative analysis of 3D images and patient satisfaction scores indicated higher satisfaction and better aesthetic outcomes in the group pre-treated with CaHA. Conclusion: The preliminary findings support the hypothesis that CaHA pre-treatment improves the structural support of the dermis and subcutaneous tissues, enhancing the efficacy of P(LA/CL) threads. Further studies are needed to confirm these results in larger cohorts and longer follow-ups, but the approach shows promise in optimizing thread-lifting procedures.