Background: Numerous fillers can be used for midface revolumization. While rheological data, physiochemical properties, and durability measured in clinical studies can inform selection, direct comparisons between equal volumes of different fillers are lacking.
Aims: To compare aesthetic improvement achieved with 3 cc of either calcium hydroxyapatite with integral lidocaine CaHA(+) or VYC-20L in the midface.
Patients/methods: In this prospective, single-center study, 17 patients with midface volume loss received 3 cc of either CaHA(+) or VYC-20L. Outcomes at post-treatment days 1, 7, 30, 90, 180, and 365 were measured by Subject and blinded Physician using the Global Aesthetic Improvement Scale (SGAIS and PGAIS). Cost per point improvement on SGAIS over time was determined.
Results: Outcomes were globally positive, with a large majority of subjects at least improved at all time points. A higher proportion of subjects were at least "very improved" in the CaHA(+) treatment group at each time point, a difference that reached significance at day 90 (100% vs 50%, P = .02), day 180 (89% vs 37.5%, P = .03), and day 360 (89% vs 37.5%, P = .03). For both SGAIS and PGAIS, only subjects within the VYC-20L cohort had "unaltered" appearance within 1 year. At 1 year, the average cost per point of SGAIS improvement for VYC-20 was approximately twice that of CaHA-20L.
Conclusion: The results of this study indicate that CaHA(+) supports better, more durable outcomes than an equal volume of VYC-20L in the midface, providing a higher value to the patient.
Keywords: biostimulatory; calcium hydroxylapatite; filler; hyaluronic acid; midface rejuvenation.
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