Histological effects of a combined collagen stimulation procedure consisting of microfocused ultrasound, soft tissue filler, and Ca-HA injections.

[BACKGROUND] An increasing demand for in-office aesthetic procedures aiming to improve collagen stimulation has been reported.

[OBJECTIVE] To analyze the effects of combinations of different aesthetic collagen stimulation procedures using histological analysis.

[METHODS] Histological analysis was performed on skin samples of the excess skin of a 60-year-old patient after sub-superficial musculo-aponeurotic system facelift surgery. The excess skin before facelift surgery was divided into three areas per hemiface. Each area-with exception of area A as a control-received an isolated or combined treatment of microfocused ultrasound (MFU), injections of calcium-hydroxylapatite/hyaluronic-acid-based soft tissue filler, and microneedling. The effect of the treatments was analyzed using histological analysis with H&E coloration and PAS staining.

[RESULTS] A threefold increase of epidermal and dermal thickness was achieved by treating the skin with the proposed combined treatment comprising MFU and injections of calcium-hydroxylapatite- and hyaluronic-acid-based soft tissue fillers.

[CONCLUSION] The investigated treatments act synergistically in the production of collagen and combining these treatments allows for an increase in collagen production.