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The Injectable Midface Lift: Three Dimensional Changes in the Midface and Nasolabial Fold Following Calcium Hydroxyapatite Injection
James Gatherwright MD, Matthew Brown MD, Kristopher Katira MD, David Rowe MD
Department of Plastic Surgery, University Hospitals Case Medical Center
2014-03-14
Presenter: Kristopher Katira MD
Affidavit:
100%
Director Name: Hooman Soltanian
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background:
Three-dimensional volume changes in the midface and the Nasolabial Fold (NLF) have not been systematically studied following malar injection of Calcium Hydroxyapatite (CaHa).
Methods:
A single surgeon performed 16 hemi-facial injections in 8 fresh cadavers(5M:3F). Injections were performed in the supraperiosteal plane with standard aliquots. The VECTRA-Canfield 3D system was used to obtain sequential images pre- and post-1.5 and 3cc CaHa injections, and volume comparison measurements were performed by a single examiner.
Results:
Malar volume increased by 3.16cc and 4.94cc following injection of 1.5cc and 3cc of CaHa respectively (p=0.001). The change in volume per cubic-centimeter of CaHa injected was 2.11cc and 1.65cc for the 1.5cc and 3cc volumes respectively. The average lateral movements of the NL crease at the level of the oral commissure, philtral columns, and nasal sill were 2.7, 2.5, and 1.9mm after 1.5cc and 2.8, 2.9, and 2.4mm after 3cc. There was a net decrease in the volume of the NLF of -0.3cc and -0.4cc following the 1.5cc and 3cc injections. This corresponded to relative volume decrease of -0.2 and -0.27 cc per CaHa volume. Anatomical dissection verified that injection were isolated to the middle malar fat pad immediately and >24hours post injection.
Conclusion:
Malar CaHa injection was associated with larger volume increases than that injected, relatively decreased volume inferiorly and medially, and was also associated with lateral movement and decreased volume of the NLF. This combination of findings indicates a lifting effect with recruitment of ptotic tissue volume post-injection.
