下顔面の肌質とシワを改善する表面MFU-Vと希薄カルシウムハイドロキシアパタイト
This single-center pilot study evaluated whether one treatment session combining superficial microfocused ultrasound with visualization (MFU-V, Ultherapy, 1.5 mm transducer) and diluted calcium hydroxylapatite (CaHA, Radiesse, diluted 1:1 with saline and injected in the subdermal plane with a cannula) improves lower face skin quality and fine wrinkles in women aged 35 to 60 years.
Participants received a single combined treatment and were followed for 24 weeks, with assessments at baseline and at 4, 12 and 24 weeks after treatment. Skin surface texture and wrinkle dimensions were measured with the Quantificare LifeViz Micro 3D imaging system. Secondary assessments included wrinkle grading on the Modified Fitzpatrick Wrinkle Scale, visual aesthetic improvement, participant satisfaction, and treatment-related adverse events.
調査の概要
詳細な説明
Aging, genetics and environmental factors contribute to multiple changes on the surface of the skin. These present with pigmentation, volume loss, loss of elasticity and loss of collagen. Altogether, areas of the face becomes "crepey", with resulting rhytids and an obvious appearance of thin and fragile skin. These are typically dermal manifestations of elastin and collagen loss resulting in a collective term of loss of "skin quality".
Current treatments to improve these changes involve the use of skincare, chemical peels, as well as more invasive repeated treatments such as microneedling and laser resurfacing. These commonly require repeated treatments and several days of downtime. More recently, treatment with a hybrid preparation of high and low-molecular weight complexes that are thermally cross-linked (Profhilo) has been suggested to stimulate collagen and elastin formation, thereby resulting in improvement in skin quality However, the evidence for this remains limited. Microfocused Ultrasound with Visualization (MFU-V) and Calcium hydroxylapatite (CaHA) have each been unequivocally proven to stimulate neocollagenesis and elastogenesis, leading to improvement in skin laxity. A recent study of a single-treatment single-depth of superficial MFU-V was found to result in aesthetic improvement of the accordion lines. In addition, there is recent evidence that CaHA in a hyperdiluted form can stimulate collagen and elastin formation. Indeed, this group of investigators has recently published the effectiveness of a single treatment of a combination MFU-V and diluted CaHA for improving brachial skin laxity. Arguably, there is a need to publish additional studies on these interventions for improving firmness and skin quality. In addition, there may be a theoretical cumulative benefit in using both treatments for improving skin quality, although the effectiveness of this combination has not been demonstrated.
With this background, the main rationale of performing this study is to demonstrate the safety and efficacy of a multimodality approach with a single treatment of superficial MFU-V and diluted CaHA for improvement of skin quality in Asian and Caucasian patients. The investigators selected Lower Face as the target area for the following reasons: 1) The Lower Face manifests the greatest with thinning, fine wrinkling and general fragility of the skin, 2) Volumization is not always aesthetically pleasing in this area but firmness of the skin is, 3) This area is an established treatment area for MFU-V, CaHA but not with other treatment options such as Profhilo.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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-
Singapore
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Singapore、Singapore、シンガポール、228210
- Cutis Medical Laser Clinics
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Female patients with lower face wrinkles
- Otherwise generally healthy.
- Physically and mentally capable to provide informed consent to the study.
- Agreement to attend all follow-up visits as scheduled
Exclusion Criteria:
- Pregnancy or lactation;
- History of allergic reaction to calcium hydroxylapatite injection;
- Active local infections or skin diseases that might alter wound healing
- Acne or keloidal scarring
- Use of immunosuppressive drugs
- Any other diseases which can affect the wound-healing process
- Any procedures affecting facial wrinkles or skin quality in the lower face for the duration of the study
- Microdermabrasion and Peels
- Acne treatments
- Filler and Botulinum Toxin treatments
- Radiofrequency, Laser, IPL, Ultrasound
- Patients that had cosmetic treatments within 3 months of the baseline visit in the treatment area
- Subjects with dermatologic conditions in the treatment area including:
- Acne
- Rosacea
- Eczema
- Psoriasis
- Actinic keratosis,
- Severe sun damage
- Scars or a history of keloids
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:順次割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Ultherapy and Radiesse
Delivered to the lower face areas as drawn using a single transducer with a focal depth of 1.5mm (following a previously published paper (Lowe, 2021) but with extension of the lower treatment area to the two-ruler width (Ulthera marking ruler) as treatment zones. Application will be delivered through a cross-hatching technique. Immediately following MFU-V or up to a week after, diluted CaHA will be administered following the Global Consensus Guidelines published in 2018 by de Almeida et al as follows 1) 1 syringe or 1.5ml of CaHA diluted 1:1 with saline for a total of 3ml of solution or 1.5 diluted CaHA per side will be injected in the subdermal plane with a cannula using a retrograde fanning technique. |
The Ulthera System is indicated for: - Use for noninvasive dermatological sculpting and lifting of the dermis: Upper Face, Lower Face, Neck, Décolletage. - Non-invasive treatment of Axillary Hyperhidrosis Radiesse injectable implant is an opaque, sterile, non-pyrogenic, semi-solid, cohesive implant. The principal component is synthetic CaHA (particle size 25-45 microns) suspended in a gel carrier of sterile water for injection, glycerin and sodium carboxymethylcellulose. In this study, one 1.5 mL syringe of Radiesse was diluted 1:1 with saline (3.0 mL total, 1.5 mL per side) and injected in the subdermal plane of the lower face with a cannula using a retrograde fanning technique, immediately after or up to one week after MFU-V. |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Skin Quality
時間枠:1 Month, 3 Months and 6 Months post intervention
|
Pre and post treatment comparison of change in skin quality. These will be measured using Quantificare LifeViz Micro, an established tool to objectively measure and validate treatment results of skin quality which will allow to accurately quantify changes with specific measurement tools. |
1 Month, 3 Months and 6 Months post intervention
|
|
Change in Wrinkle Reduction
時間枠:1 Month, 3 Months and 6 Months post intervention
|
Pre and post treatment comparison of change in dimensions of fine lines (volume/depth/length). These will be measured using Quantificare LifeViz Micro, an established tool to objectively measure and validate treatment results of lines, which will allow to accurately quantify changes with specific measurement tools. |
1 Month, 3 Months and 6 Months post intervention
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Visual Aesthetic Improvement Score
時間枠:1 Month, 3 Months and 6 Months post intervention
|
Pre and post treatment comparison of Visual Aesthetic Improvement Score of standardized patient photographs by study investigators. Both VISIA Imaging photographs and standard photographs will be used. |
1 Month, 3 Months and 6 Months post intervention
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Patient Satisfaction
時間枠:1 Month, 3 Months and 6 Months post intervention
|
To evaluate patient satisfaction of change of lower face skin quality using a 5 point scale where 1 means strongly disagree and 5 means strongly agree. |
1 Month, 3 Months and 6 Months post intervention
|
|
Establish Number of Adverse Events
時間枠:1 Month, 3 Months and 6 Months post intervention
|
Count the number of participants with treatment-related adverse events as assessed by CTCAE v4.0 |
1 Month, 3 Months and 6 Months post intervention
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Narins RS, Carruthers J, Flynn TC, Geister TL, Gortelmeyer R, Hardas B, Himmrich S, Jones D, Kerscher M, de Maio M, Mohrmann C, Pooth R, Rzany B, Sattler G, Buchner L, Benter U, Breitscheidel L, Carruthers A. Validated assessment scales for the lower face. Dermatol Surg. 2012 Feb;38(2 Spec No.):333-42. doi: 10.1111/j.1524-4725.2011.02247.x.
- Shoshani D, Markovitz E, Monstrey SJ, Narins DJ. The modified Fitzpatrick Wrinkle Scale: a clinical validated measurement tool for nasolabial wrinkle severity assessment. Dermatol Surg. 2008 Jun;34 Suppl 1:S85-91; discussion S91. doi: 10.1111/j.1524-4725.2008.34248.x.
- Information and Instruction Manual for Cutometer® dual MPA 580. English 2019/02 DK. [Available from: https://www.courage-khazaka.de/en/16-wissenschaftliche-produkte/alle-produkte/178-cutometer-e
- Lowe S. Single Treatment, Single Depth Superficial Microfocused Ultrasound with Visualization for Rhytid Improvement. Plast Reconstr Surg Glob Open. 2021 Jul 13;9(7):e3662. doi: 10.1097/GOX.0000000000003662. eCollection 2021 Jul.
- Ramirez S, Puah IBK. Effectiveness of combined microfocused ultrasound with visualization and subdermal calcium hydroxyapatite injections for the management of brachial skin laxity. J Cosmet Dermatol. 2021 Dec;20(12):3871-3879. doi: 10.1111/jocd.14573. Epub 2021 Oct 29.
- de Almeida AT, Figueredo V, da Cunha ALG, Casabona G, Costa de Faria JR, Alves EV, Sato M, Branco A, Guarnieri C, Palermo E. Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent. Plast Reconstr Surg Glob Open. 2019 Mar 14;7(3):e2160. doi: 10.1097/GOX.0000000000002160. eCollection 2019 Mar.
- Casabona G, Michalany N. Microfocused ultrasound with visualization and fillers for increased neocollagenesis: clinical and histological evaluation. Dermatol Surg. 2014 Dec;40 Suppl 12:S194-8. doi: 10.1097/DSS.0000000000000231. No abstract available.
- Goldie K, Peeters W, Alghoul M, Butterwick K, Casabona G, Chao YYY, Costa J, Eviatar J, Fabi SG, Lupo M, Sattler G, Waldorf H, Yutskovskaya Y, Lorenc P. Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening. Dermatol Surg. 2018 Nov;44 Suppl 1:S32-S41. doi: 10.1097/DSS.0000000000001685.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- Cutis
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
No individual participant data will be shared.
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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