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.