![]() Patients frequently request a taut jawline (also known as a “snatched” jawline) that clearly delineates the face from the neck, and gives rise to a shadow cast from the jawline onto the neck. The contribution of jawline contour to facial attractiveness is substantial, and a wide range of patients (all genders and across a large age range) frequently request treatments aimed at jawline beautification/aesthetic improvement and/or rejuvenation. 16 With age, the chin also shortens, resulting in decreased projection, which can affect the apparent length of the mandible. 15–17 One of the most notable changes in facial structure that occurs with aging is a loss, lack, or blunting of the mandibular angle as well as loss of definition along the jawline, which occurs due to a combination of skeletal remodeling and resorption as well as tissue laxity and loss of volume in the fat pads of the lower face. Overall, facial aging is a multifactorial process that is caused by a combination of elastin, collagen, and glycosaminoglycan breakdown fat displacement and decreases in volume changes in muscle tension and length and resorption of bony structures. ![]() The jawline is an area of the face especially prone to exhibiting signs of aging as a result of skeletal changes and soft tissue volume loss. Thus, CaHA(+) is and is particularly well-suited for the augmentation of jawline contour. Clinically, CaHA/CaHA(+) is an ideal product for replacing volume and bony support that have been lost, primarily due to its capacity to provide structural support. 6, 8, 10, 11 Importantly, the high G′ and viscosity of CaHA and CaHA(+) make this agent well-suited for placement on periosteum, where it can lift overlying tissue and serve as a modulable implant that retains shape, which uniquely allows for a defined edge and projection. 8–10 Togehter, these activities not only give rise to a longer-term aesthetic correction, but also improve the quality of overlying skin. 4–6 As the carrier gel dissipates, the microspheres interact with the tissue matrix, directly stimulating dermal fibroblasts to produce endogenous collagen types I and III, increasing elastogenesis, and additionally increasing proteoglycans and angiogenesis. 4, 5, 7 CaHA and CaHA(+) are unique among biostimulatory fillers in that they provide volume through a dual mechanism which includes both the provision of immediate volume through the lifting capacity of the CaHA microspheres and carboxymethylcellulose gel, as well as regeneration of multiple components of the extracellular matrix. 4–6 The CaHA(+) formulation differs from CaHA in that it also contains 0.3% integral lidocaine hydrochloride for improved patient comfort however, the formulations have similar clinical performance and flow properties. 1, 2ĬaHA/CaHA(+) is a biodegradable filler that contains 25-45 µm CaHA microspheres composed of phosphate and calcium ions (the main minerals in teeth and bones) 3 suspended in a carboxymethylcellulose-based carrier gel. ![]() 1 Dermal fillers are second only to botulinum toxin as the most popular noninvasive aesthetic treatments, with hyaluronic acid (HA) and calcium hydroxyapatite (CaHA and CaHA(+) Radiesse and Radiesse(+) ), ranking as the most popular fillers. ![]() The development and adoption of minimally invasive modalities for improving facial contour and volume has led to an increased interest in aesthetic procedures, and in 2020 the number of noninvasive procedures outpaced surgical procedures (13,281,235 vs 2,314,720, respectively).
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