title: Large-particle calcium hydroxylapatite injection for correction of facial wrinkles and depressions.
abstract: BACKGROUND
  Small-particle calcium hydroxylapatite (Radiesse, Merz, Frankfurt, Germany) is safe and effective for facial wrinkle reduction, and has medium-term persistence for this indication. There is patient demand for similar fillers that may be longer lasting.
  
  
  OBJECTIVE
  We sought to assess the safety and persistence of effect in vivo associated with use of large-particle calcium hydroxylapatite (Coaptite, Merz) for facial augmentation and wrinkle reduction.
  
  
  METHODS
  This was a case series of 3 patients injected with large-particle calcium hydroxylapatite.
  
  
  RESULTS
  Large-particle calcium hydroxylapatite appears to be effective and well tolerated for correction of facial depressions, including upper mid-cheek atrophy, nasolabial creases, and HIV-associated lipoatrophy. Adverse events included erythema and edema, and transient visibility of the injection sites. Treated patients, all of whom had received small-particle calcium hydroxylapatite correction before, noted improved persistence at 6 and 15 months with the large-particle injections as compared with prior small-particle injections.
  
  
  CONCLUSIONS
  This is a small case series, and there was no direct control to compare the persistence of small-particle versus large-particle correction.
  
  
  CONCLUSIONS
  For facial wrinkle correction, large-particle calcium hydroxylapatite has a safety profile comparable with that of small-particle calcium hydroxylapatite. The large-particle variant may have longer persistence that may be useful in selected clinical circumstances.
authors.affiliation: Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA. m-alam@northwestern.edu
authors.forename: Murad
authors.initials: M
authors.lastname: Alam
authors.forename: Jillian
authors.initials: J
authors.lastname: Havey
authors.forename: Natalie
authors.initials: N
authors.lastname: Pace
authors.forename: Marisa
authors.initials: M
authors.lastname: Pongprutthipan
authors.forename: Simon
authors.initials: S
authors.lastname: Yoo
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D003357:Cosmetic Techniques; D017886:Durapatite / Q000627:therapeutic use*; D004954:Esthetics; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D010316:Particle Size; D017060:Patient Satisfaction; D010865:Pilot Projects; D012060:Rejuvenation / Q000502:physiology; D012307:Risk Factors; D012494:Sampling Studies; D015595:Skin Aging / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite