title: Calcium hydroxylapatite for jawline rejuvenation: consensus recommendations.
abstract: BACKGROUND
  Age-associated volume loss is now known to play an important role in the structural changes of the aging face. In the lower face, this manifests as drooping of the corners of the mouth and jowl leading to a loss of the oval jawline of youth. Jawline reshaping by replacing volume has therefore become an indispensable component of modern facial rejuvenation.
  
  
  OBJECTIVE
  Calcium hydroxylapatite (CaHA; Radiesse® , Merz Pharmaceuticals GmbH, Frankfurt, Germany) is an injectable filler with a cosmetic indication for tissue augmentation. The ability of calcium hydroxylapatite to provide immediate and long-lasting volume enhancement makes it an ideal agent for restoring an oval jawline.
  
  
  METHODS
  This consensus statement has been developed to assist clinicians who would like to gain more experience in the use of volumizing agents to achieve an optimal outcome with this procedure.
  
  
  RESULTS
  Using the recently developed Merz Aesthetics Scale® for jawline, the consensus provides a treatment protocol for individuals at each stage of oval loss and presents a series of before and after images to illustrate the improvements that can be achieved. Specific recommendations for calcium hydroxylapatite including type of anesthesia, injection techniques, volume for injection, use in combination with other procedures, and expected duration of corrections are provided. Techniques for minimizing and managing expected problems and potential complications are also described.
  
  
  CONCLUSIONS
  Calcium hydroxylapatite is appropriate for treating patients at any stage of oval loss.
authors.affiliation: Centre Laser Dermatologique Laser MD, Strasbourg, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Dallara
authors.forename: Martine
authors.initials: M
authors.lastname: Baspeyras
authors.forename: Patrick
authors.initials: P
authors.lastname: Bui
authors.forename: Hugues
authors.initials: H
authors.lastname: Cartier
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Charavel
authors.forename: Laurent
authors.initials: L
authors.lastname: Dumas
mesh_terms: D032921:Consensus; D003879:Dermatologic Agents / Q000008:administration & dosage*; D017886:Durapatite / Q000008:administration & dosage*; D004954:Esthetics; D005145:Face; D006801:Humans; D007271:Injections, Intradermal; D017410:Practice Guidelines as Topic; D012060:Rejuvenation; D015595:Skin Aging
chemical_list: D003879:Dermatologic Agents; D017886:Durapatite
keywords: Merz Aesthetics Scales; calcium hydroxylapatite; facial rejuvenation, jawline; volume enhancement