A Novel Six-Point Supraperiosteum Injection with Calcium Hydroxyapatite for Jawline Refining and Facial Anti-aging in Asian Patients

Abstract Background Supraperiosteal injection by calcium hydroxyapatite (CaHA) fillers is an efficient treatment for facial rejuvenation to achieve bony recontouring, facial augmentation and lifting. However, a safe and efficient injection technique for Asians was not described, and an assessment scale to quantify “facial anti-aging” does not exist. Methods We enrolled 16 Asian women ( n = 32) to receive a single session of six-point calcium hydroxyapatite (CaHA, Radiesse® Plus) filler injections between July 1, 2021, and July 1, 2022. The six injection sites included the eyebrow arch, lateral eyebrow, lateral zygoma, piriform fossa, lateral chin, and anteromedial cheek. Efficacy was assessed at weeks 0 (immediately post-treatment), 4, 12, and 24 using a specialized angular and length measurement system, with outcomes further evaluated using an 11-level anti-aging scale. Results Among the four angular and six linear parameters assessed, statistically significant variations were observed across five time points. Regarding post hoc analyses, the Eyebrow-Tail angle showed a statistically significant change at week 24, increasing by 2.84° ( p < 0.001) and corresponding to an anti-aging scale value of 6. This parameter indicated eyebrow lifting. The Tragus-Oral (−10.4 mm, p = 0.004) and Lower Facial Contouring (−9.8 mm, p = 0.044) showed statistically significant reductions and received aging scale ratings of 10 and 9, respectively, at week 24. These two parameters indicated achieving jawline refining. Overall, the final anti-aging scale improved from an average of 50–59, with minimal or ignorable ecchymosis and swelling at week 24. Conclusions The 6-point calcium hydroxyapatite filler injection achieved facial rejuvenation. After a single session, the injection recontoured the jawline and lifted the eyebrow tail. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266