Effectiveness of combined microfocused ultrasound with visualization and subdermal calcium hydroxyapatite injections for the management of brachial skin laxity

BACKGROUND: There is no publication to date on the combined use of microfocused ultrasound with visualization (MFU‐V) and calcium hydroxylapatite (CaHA) for brachial skin laxity. AIM: To assess the effectiveness of combining MFU‐V with diluted/hyperdiluted CaHA in a single session for treating brachial skin laxity. SUBJECTS/METHODS: Female subjects who had skin laxity in the brachial regions and who desired non‐surgical intervention were enrolled into this prospective, single‐arm pilot study. MFU‐V (Ultherapy(®), Merz North America, Inc. Raleigh, N.C.) was applied using the 4.0 MHz‐4.5 mm and 7.0 MHz‐3.0 mm depth transducers, followed by subdermal injections of diluted (1:1)/hyperdiluted (1:2) CaHA (Radiesse(®), Merz North America, Inc). Subjects were followed for six months after treatment. Objective biophysical skin assessments were conducted using a cutometer (Cutometer(®) Dual 580 MPA; Courage & Khazaka, Cologne, Germany). Subjective assessments included the arm visual analogue scale (VAS), global aesthetic improvement scale (GAIS), and subject global satisfaction scale. RESULTS: Twelve subjects participated in the study. The mean R0 reading (measure of skin firmness) progressively improved from 0.515 mm at baseline to 0.433 mm at 24 weeks (p < 0.05 for 12 and 24 weeks). The mean R2 reading (measure of skin elasticity) and mean arm VAS improved significantly from baseline at all visits (p < 0.05 for all). The majority of subjects at each visit showed improved arm appearance and were satisfied with their treatment. Both procedures were well‐tolerated. CONCLUSIONS: Combined use of MFU‐V with diluted/hyperdiluted CaHA demonstrates significant improvements in both objective and subjective measures of brachial skin laxity.