Three-Dimensional Changes in the Midface Following Malar Calcium Hydroxyapatite Injection in a Cadaver Model

Area of Science:

• Plastic Surgery
• Facial Anatomy
• Biomaterials

Background:

• Three-dimensional (3D) midface changes after malar calcium hydroxyapatite (CaHa) injections lack systematic analysis.
• Understanding these volumetric and positional shifts is crucial for aesthetic and reconstructive procedures.

Purpose of the Study:

• To quantitatively analyze 3D midface volume changes and naso-labial fold (NLF) alterations following malar CaHa injections.
• To assess lateral movement at the NLF/naso-labial crease (NLC) junction in a cadaver model.

Main Methods:

• Calcium hydroxyapatite (CaHa) was injected into the supraperiosteal plane in 16 fresh cadaver hemi-faces.
• VECTRA 3D imaging captured sequential volumetric data before and after 1.5-cc and 3-cc CaHa injections.
• Anatomical dissection confirmed injection site accuracy within the supraperiosteal space and malar fat pad.

Main Results:

• Malar CaHa injections led to increased projection at the injection site, with infero-medial volume decreases.
• Mean midface volume increased by 3.16 cc (1.5-cc injection) and 4.94 cc (3-cc injection).
• NLF volume decreased by -0.3 cc and -0.4 cc; NLF-NLC junction showed lateral movement of 1.9-2.9 mm.

Conclusions:

• 3D photographic analysis demonstrates a measurable lifting effect of malar CaHa injections.
• CaHa promotes tissue recruitment and induces lateral displacement of the NLF-NLC junction in a cadaver model.