Comparative Clinical and Histomorphologic Evaluation of the Effectiveness of Combined Use of Calcium Hydroxyapatite and Hyaluronic Acid Fillers for Aesthetic Indications

In conclusion, the data from this randomized, open, prospective, pilot, clinical study correspond to displaying the efficacy in terms of the histomorphological evaluation of the sequential injections of CPM-HA V and CaHA and simultaneous injections of CPM-HA V and CaHA. A comparative analysis of histology and immunohistochemistry of samples following the combined injection of CPM-HA V and CaHA revealed that phased injections of CPM-HA V and CaHA had a greater expected remodeling effect on one's skin compared with simultaneous injection of CPMHA V and CaHA; this is confirmed by intense elastic fiber formation (r<0.05), type I to III collagen accumulation in the dermis (r<0.05) with the preserved 1:1 ratio, and intense angiogenesis (p<0.5) that provides sustained blood supply to the tissues. There is also evidence that simultaneous injection of CPM-HA V and CaHA at the same level is safe, confirming that there are no histologic and immunohistologic signs of inflammation and disturbance of tissue trophicity. If we interpret the data obtained regarding clinical practice, we can draw the following conclusion: simultaneous injection of the studied products is possible from the point of view of safety, but different levels of administration will be more optimal, which will provide a more pronounced remodeling effect on the skin.