Radiesse (calcium hydroxylapatite) / Merz Pharma - LARVOL DELTA

Feasibility of calcium hydroxyapatite (Radiesse®) for improving the biomechanical properties of facial burn scars: A pilot study. (PubMed, JPRAS Open) - "This feasibility study indicated that subdermal CaHA injections have potential as a noninvasive approach for improving the biomechanical properties of facial burn scars. However, further studies with larger sample sizes and long-term follow-up are needed to confirm these findings."

Journal • Dermatology • Fibrosis • Immunology • Thermal Injury

Sonographic Analysis of CureJet Injection Depth Consistency After Abdominal Stretch Mark Treatment Using Hyperdiluted Calcium Hydroxylapatite. (PubMed, Plast Reconstr Surg Glob Open) - "This study highlights the need for further refinement in injector technology and technique to improve uniformity in treatment depth, particularly for applications like scar treatment and stretch mark reduction. Enhancing precision in such devices could lead to better patient outcomes and increased safety in aesthetic treatments."

Journal • Aesthetic Medicine

Evaluation of the Effectiveness and Safety of Diluted RADIESSE® in the Treatment of Décolleté Wrinkles (clinicaltrials.gov) - P=N/A | N=152 | Active, not recruiting | Sponsor: Merz North America, Inc. | Completed ➔ Active, not recruiting | Trial completion date: Nov 2023 ➔ May 2025

Enrollment closed • Trial completion date

In Vitro Comparative Study of Calcium Hydroxyapatite (Stiim): Conventional Saline Dilution Versus Poly-Micronutrient Dilution. (PubMed, Cureus) - "Calcium hydroxylapatite (CaHA) is widely used in aesthetics for its dual role as a dermal filler and biostimulator, promoting collagen and elastin synthesis...CaHA/PMN outperformed conventional CaHA, with greater increases in cell viability, collagen synthesis, elastin synthesis, and the expression of SIRT-1, SIRT-3, and FOXO3. These findings suggest that poly-micronutrient-enriched solutions can enhance CaHA's regenerative potential, providing a promising approach for skin rejuvenation and elasticity improvement."

Journal • Preclinical • Aesthetic Medicine • FOXO3 • SIRT3

Hybrid Fillers Personal Experience of Premixing Calcium Hydroxylapatite and Hyaluronic Acid for Natural Face Reshaping. (PubMed, J Craniofac Surg) - "Premixing CaHA and HA offers a safe, effective, and reproducible technique for natural facial reshaping and rejuvenation. The combination enhances skin quality while providing immediate volumization and long-term collagen stimulation, meeting the aesthetic expectations of patients seeking minimally invasive anti-aging solutions."

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Panfacial Approach to Rejuvenation Using Calcium Hydroxylapatite: A Case Series Illustrating Calcium Hydroxylapatite Versatility Through Dilution and a Multilayered Treatment Approach. (PubMed, Aesthet Surg J Open Forum) - "Although undiluted product can be used to provide deeper volume and structural support in areas like the chin, jawline, and temples, more dilute product (1:1 and 1:2) can be used to provide some volume and/or smooth transitions in the face, whereas hyperdilute CaHA can be used over an even wider surface area in the face, neck, or décolletage to tighten skin and improve skin quality (1:3 and 1:4 dilutions). In the cases presented, patients achieved improvement in appearance through treatment with multiple dilutions of CaHA, providing several examples of how CaHA may be used as part of a multilayered approach to facial rejuvenation."

Journal • Aesthetic Medicine

Conditions to Consider When Choosing Fillers. (PubMed, J Cosmet Dermatol) - "Understanding the rheological and safety profiles of fillers is essential for achieving optimal aesthetic outcomes. HA fillers are recommended for novice practitioners due to their reversibility, while experienced clinicians may explore non-HA options. Tailored filler selection based on rheological properties and clinical context ensures safer and more effective treatments."

Journal • Review • Aesthetic Medicine • Inflammation

Comparative Bulk RNA-seq Analysis of Poly-L-Lactic Acid vs Calcium hydroxylapatite Reveals PLLA has an Adipocyte Mediated Regenerative Mechanism of Action (AAD 2025) - "Further, the adipokines that appear to be upregulated are regenerative with a positive impact on skin health. Summary: PLLA-SCA has a novel signature which may support a potential regenerative mechanism of action via the role in the modulation of adipocyte function."

Three Calcium Hydroxylapatite-Based Dermal Fillers Marketed in Mexico: Comparison of Particle Size and Shape Using Electron Microscopy. (PubMed, J Cosmet Dermatol) - "Gaining a deeper understanding of these differences enables the improved development of dermal fillers to meet the growing demand for safe and effective aesthetic treatments. This study contributes to building knowledge about the use of microparticles in soft tissue fillers for aesthetic treatments and medical applications."

Clinical • Journal • Aesthetic Medicine • Dermatology

Labia Majora Rejuvenation With Hybrid Filler: A Narrative Review of the Literature and Report of Two Cases. (PubMed, J Cosmet Dermatol) - "These two case reports and a narrative literature review suggest that a combined HA/CaHA filler may be a safe and effective treatment for labia majora rejuvenation."

Journal • Review • Aesthetic Medicine • Gynecology

Multilayer Technique Using Calcium Hydroxylapatite Biostimulation With Different Dilutions in the Lateral Face. (PubMed, Aesthet Surg J Open Forum) - "The technique described in this pilot study provides a full-face approach with CaHA based on the current concepts of the line of ligaments and facial biomechanics. Further studies are needed to validate the results."

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Characterization of Particles From Collagen Bio-Stimulating Materials Used in Facial Filling Procedures. (PubMed, Microsc Res Tech) - "Five collagen bio-stimulating materials were evaluated: Radiesse, Rennova Diamond, HarmonyCa, Victalab Bio-stimulator, and Optimus Bio-stimulator...FTIR analyzes showed that all materials presented CaHA with similar composition. It can be concluded that the collagen bio-stimulator materials presented different inorganic contents in terms of size and morphology."

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Arterioembolic Characteristics of Differentially Diluted CaHA-CMC Gels Within an Artificial Macrovascular Perfusion Model. (PubMed, Aesthet Surg J) - "Embolized CaHA-CMC gels produce polydisperse particle mixtures with a preponderance of microparticles. Hyperdilution profoundly reduced the proximally occlusive potential of the product."

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Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite. (PubMed, Plast Reconstr Surg Glob Open) - No abstract available

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Reply: Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite. (PubMed, Plast Reconstr Surg Glob Open) - No abstract available

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Using Calcium Hydroxylapatite to Treat Gum Recession and Tooth Hypersensitivity (clinicaltrials.gov) - P=N/A | N=500 | Enrolling by invitation | Sponsor: American Academy of Facial Esthetics

New trial • Immunology

Commentary on: Aesthetic Efficacy and Safety of Combined Microfocused Ultrasound with Visualization and Calcium Hydroxylapatite Treatment: A Systematic Review of Human Evidence. (PubMed, Aesthet Surg J) - No abstract available

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Aesthetic Efficacy and Safety of Combined Microfocused Ultrasound With Visualization and Calcium Hydroxylapatite Treatment: A Systematic Review of Human Evidence. (PubMed, Aesthet Surg J) - "Our review highlights promising outcomes from combined MFU-V and CaHA-CMC treatment. Nevertheless, due to the limited number of studies, further research is essential to gain a deeper understanding of this combined treatment's efficacy, safety, and applicability."

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A Systematic Review and Meta-analysis of Single-group Studies Assessing the Role of Calcium Hydroxylapatite in Aesthetic Enhancements and Satisfaction. (PubMed, Plast Reconstr Surg Glob Open) - "However, studies focusing on nonfacial regions are limited. We recommend more rigorously designed trials to better understand CaHA's clinical effects."

Journal • Retrospective data

A Systematic Review on the Effectiveness and Safety of Combining Biostimulators with Botulinum Toxin, Dermal Fillers, and Energy-Based Devices. (PubMed, Aesthetic Plast Surg) - "The review underscores the potential benefits of combined treatments in aesthetic outcomes, though limitations like heterogeneous methodologies, small sample sizes, and inconsistent protocols impact the reliability of findings. Current literature lacks a molecular understanding of the mechanisms underlying these combinations, limiting insights into the longevity and safety of results. Future studies with standardised protocols, objective outcome measures, and detailed molecular analyses are essential for developing evidence-based recommendations for combining biostimulators with other treatments in aesthetic practice."

Journal • Review • Aesthetic Medicine • Dermatology

Spontaneous and induced degradation of dermal fillers: A review. (PubMed, J Cutan Aesthet Surg) - "Semipermanent fillers are poly-(D), l-lactic acid and calcium hydroxylapatite...Intralesional laser treatment supports the removal of permanent filler material as an alternative to surgery. Besides biocompatibility and toxicity, filler materials should also be assessed for degradation to improve patient safety."

Journal • Review • Aesthetic Medicine

Diamond Technique: A Triple Treatment for Neck and Décolletage Rejuvenation. (PubMed, J Cosmet Dermatol) - "While the authors assert the technique's safety and efficacy, the need for controlled studies is crucial. Rigorous, long-term studies are warranted to validate its effectiveness and safety compared with the existing approaches."

Journal • Aesthetic Medicine

Treatment of Mid-Face Aging with Calcium Hydroxylapatite: Focus on Retaining Ligament Support. (PubMed, Clin Cosmet Investig Dermatol) - "While injectable hyaluronic acid implants have been used to improve ligament support, calcium hydroxylapatite has one of the highest viscoelasticities when compared with other dermal fillers and can induce collagen synthesis, which could provide long-term laxity correction. In this preliminary report of a case series, our goal was to describe the use of calcium hydroxylapatite in different dilutions and combinations for different aging profiles to treat the midface as an alternative for hyaluronic acid injections and to describe the ultrasonographic behavior in the long run."

Journal • Aesthetic Medicine

Microfocused Ultrasound With Visualization (MFU-V) and Hyperdilute Calcium Hydroxylapatite (CaHA-CMC) of the Lower Face and Submentum to Treat Skin Laxity: A Pilot Study Demonstrating Superiority of MFU-V First Followed by Hyperdilute CaHA-CMC. (PubMed, Aesthet Surg J) - "Administering MFU-V first, followed by hyperdilute CaHA-CMC six weeks later, is the optimal sequence for this combination therapy. Although both groups experienced increased elastin synthesis and aesthetic improvements, the order of treatments significantly impacted the outcomes, favoring the sequence used in Group A. This finding provides valuable insight for optimizing combination therapies in aesthetic dermatology."

Head-to-Head • Journal • Aesthetic Medicine • Dermatology

Plain language summary of the pivotal study of calcium hydroxylapatite with lidocaine for improvement of jawline contour. (PubMed, J Dermatolog Treat) - P=N/A | "This summary is for patients and others interested in learning about how CaHA (+) works, its safety, and its ability to improve jawline shape.Who sponsored this study? The study was sponsored by Merz North America, Inc."

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