Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage

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Skin laxity and wrinkling on the neck and décolletage reveal age as reliably as the face.


To evaluate the combined use of microfocused ultrasound with visualization (MFU-V; Ultherapy®) and diluted calcium hydroxylapatite (CaHA; Radiesse®) for treating the neck and décolletage.


Subjects with moderate-to-severe lines on the neck and/or décolletage were retrospectively enrolled. MFU-V was applied using 7 and 10 MHz transducers followed by subdermal injection of CaHA diluted 1:1 with lidocaine solution. Photographs at baseline and 90 days were assessed by two independent, blinded evaluators using three scales: Merz Aesthetics décolleté wrinkles, Fabi-Bolton chest wrinkle, and Allergan transverse neck lines scales.


A total of 47 subjects were treated as follows: 29 (neck only), five (décolletage only), and 13 (both areas). Mean neckline score improved from 2.6 (moderate-to-severe lines) at baseline to 1.3 (mild lines) 90 days after treatment (P < .001). Mean décolletage scores improved from 2.6 and 3.3 (moderate-to-severe wrinkles) on the Merz Aesthetics and Fabi-Bolton scales, respectively, to 1.1 and 1.8 (mild wrinkles), respectively, after treatment (both P < .001). Both procedures were well tolerated with high subject satisfaction.


Combining MFU-V with 1:1 diluted CaHA is effective for improving the appearance of neck and décolletage lines and wrinkles.

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