BIO3 Protocol: Clinical and In Vitro Evidence of Triple Biostimulation With CaHA and P (LA/CL) Threads

Area of Science:

• Dermatology and Aesthetic Medicine
• Biomaterials Science
• Regenerative Medicine

Background:

• Facial aging involves extracellular matrix (ECM) deterioration, volume loss, and sagging.
• Absorbable threads offer mechanical support and biostimulation but may be less effective in poor dermal quality.
• Calcium Hydroxyapatite (CaHA) is a known biostimulator promoting collagen and elastin synthesis.

Purpose of the Study:

• To evaluate the synergistic effects of combining CaHA with polydioxanone (P) threads (LA/CL-based) on ECM remodeling and clinical outcomes.
• To assess the biological and clinical performance of the BIO3 protocol through in vitro gene expression and retrospective clinical data.

Main Methods:

• In vitro full-thickness human skin model to analyze COL1A1, COL3A1, and ELN gene expression after treatment with CaHA, P threads, or both.
• Retrospective clinical study involving 11 female patients (35-65 years) undergoing facial rejuvenation with threads alone or preceded by CaHA.
• Clinical outcomes assessed via GAIS, WSRS, laxity scores, ultrasound, and satisfaction questionnaires.

Main Results:

• Combined in vitro treatment significantly upregulated ECM genes more than monotherapies.
• All patients experienced aesthetic improvement; the CaHA/P thread group showed greater dermal/subcutaneous thickening and higher GAIS ratings at 120 days.
• 100% patient satisfaction was achieved by day 30 in both groups and maintained, with no adverse events reported.

Conclusions:

• The BIO3 protocol, combining CaHA and P threads, demonstrates synergistic benefits for ECM remodeling and aesthetic results.
• This supports the clinical application of layered and sequential biostimulation strategies for facial rejuvenation.
• The study highlights a promising approach to enhance outcomes in patients with aging skin concerns.