Exploratory Analysis of Age-Related Trends in Biostimulatory Response to Combined Calcium Hydroxylapatite-Carboxymethylcellulose and Microfocused Ultrasound With Visualization Treatments

Abstract Background Biostimulators and energy-based devices are increasingly used in combination to address visible signs of aging. Previous research demonstrated that pairing microfocused ultrasound with visualization (MFU-V) and hyperdiluted calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) enhances dermal elastin synthesis and improves aesthetic outcomes up to 120 days posttreatment. However, the impact of patient age on the histological response to these treatments remains unclear. Objectives To explore whether age influences the biostimulatory response to combined hyperdiluted CaHA-CMC and MFU-V treatments in healthy adults aged 39 to 62 years. Methods This secondary analysis leveraged data from a 12-patient, IRB-approved clinical study in which patients received 2 combination treatment protocols: Group A (MFU-V followed by hyperdiluted CaHA-CMC) and Group B (hyperdiluted CaHA-CMC followed by MFU-V). Biopsies obtained before and 120 days after completion of treatments were stained for elastin and quantitatively assessed. Linear regression analyses assessed correlations between age and changes in elastin staining intensity and area coverage. Results No significant correlation was found between patient age and changes in dermal elastin intensity or area. In subgroup analyses, neither protocol showed a significant age-dependent difference in elastin intensity. Although 1 subgroup (Group B) revealed a marginal correlation between age and elastin area, the pooled data did not support age as a significant predictor of biostimulatory response. Conclusions This exploratory analysis suggests that within the studied age range, patient age may not significantly influence the histological response to combined CaHA-CMC and MFU-V treatments. Larger, statistically powered studies are needed to validate these findings and further investigate age-related effects. Level of Evidence: 5 (Therapeutic)