Exploratory Analysis of Age-Related Trends in Biostimulatory Response to Combined Calcium Hydroxylapatite-Carboxymethylcellulose and Microfocused Ultrasound With Visualization Treatments

Abstract

Background: Biostimulators and energy-based devices are increasingly used in combination to address visible signs of aging. Previous research demonstrated that pairing microfocused ultrasound with visualization (MFU-V) and hyperdiluted calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) enhances dermal elastin synthesis and improves aesthetic outcomes up to 120 days posttreatment. However, the impact of patient age on the histological response to these treatments remains unclear.

Objectives: To explore whether age influences the biostimulatory response to combined hyperdiluted CaHA-CMC and MFU-V treatments in healthy adults aged 39 to 62 years.

Methods: This secondary analysis leveraged data from a 12-patient, IRB-approved clinical study in which patients received 2 combination treatment protocols: Group A (MFU-V followed by hyperdiluted CaHA-CMC) and Group B (hyperdiluted CaHA-CMC followed by MFU-V). Biopsies obtained before and 120 days after completion of treatments were stained for elastin and quantitatively assessed. Linear regression analyses assessed correlations between age and changes in elastin staining intensity and area coverage.

Results: No significant correlation was found between patient age and changes in dermal elastin intensity or area. In subgroup analyses, neither protocol showed a significant age-dependent difference in elastin intensity. Although 1 subgroup (Group B) revealed a marginal correlation between age and elastin area, the pooled data did not support age as a significant predictor of biostimulatory response.

Conclusions: This exploratory analysis suggests that within the studied age range, patient age may not significantly influence the histological response to combined CaHA-CMC and MFU-V treatments. Larger, statistically powered studies are needed to validate these findings and further investigate age-related effects.

Figure 1.

(A) Average patient age in Groups A and B. (B) Average BMIs of patients in Groups A and B throughout the course of the study.

Figure 2.

Elastin van Gieson stain highlighting elastic fibers (black) (A) before and (B) 120 days after combined MFU-V/CaHA-CMC treatment in a 39-year-old patient and (C) before and (D) 120 days after combined MFU-V/CaHA-CMC treatment in a 62-year-old patient. CaHA-CMC, calcium hydroxylapatite-carboxymethylcellulose; MFU-V, microfocused ultrasound with visualization.

Figure 3.

Pooled linear regression analysis illustrating the lack of significant correlation between patient age and (A) change in histological elastin stain intensity (brightness of stain) and (B) change in elastin-positive areas of histological samples. Although 12 data points are present, 2 data points overlap because of similar values and may appear as a single point at this resolution.

Figure 4.

Subgroup linear regression analysis illustrating the relationship between patient age and (A) change in histological elastin stain intensity (brightness of stain) and (B) change in elastin-positive areas of histological samples in Groups A and B. Although 12 data points are present, 2 data points overlap because of similar values and may appear as a single point at this resolution.