摘要

Objectives: To evaluate the efficacy and safety of personalized CaHA protocols tailored to atrophic (AP) and hypertrophic (HP) photoaging types. Introduction: Existing CaHA filler protocols for facial rejuvenation typically use skin thickness as a guide, but this parameter is difficult to measure and standardize in practice. Despite clear clinical differences between photoaging phenotypes, no previous studies have proposed treatment strategies based on these patterns. Materials / method: A retrospective study assessed outcomes of CaHA treatments using pure (30%) or hyperdiluted (1:2) techniques, alone or combined, according to photoaging phenotype. Efficacy was evaluated at 6 months using validated mid- and lower-face severity scales, Lemperle wrinkle scale, and Global Aesthetic Improvement Scale (GAIS). Safety was monitored throughout follow-up. Results: Among 157 patients (mean age 62 ± 7.4 years), all severity scores improved significantly (p < 0.001), with overall severity decreasing from 16.4 ± 4.2 to 7.0 ± 2.2. HP patients achieved greater improvements in marionette lines, nasolabial folds, and Lemperle scores (p ≤ 0.028), particularly with combined protocols, while AP patients benefited most in correcting sunken areas (p = 0.000) using pure CaHA. GAIS indicated high satisfaction (94% “improved” or better). No major adverse events occurred; minor effects resolved spontaneously. Conclusion: This is the first study to demonstrate that tailoring CaHA protocols to photoaging phenotype—rather than relying on skin thickness—significantly enhances outcomes and patient satisfaction, supporting a shift toward personalized, evidence-based facial rejuvenation.