Hyperdiluted calcium hydroxylapatite for skin laxity and cellulite of the skin above the knee: A pilot study

Stefania Guida, Sabrina Longhitano, Kaleci Shaniko, Hassan Galadari, Johanna Chester, Silvana Ciardo, Victor Desmond Mandel, Giovanni Pellacani, Giacomo Giovanni Urtis, Francesca Farnetani

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Despite an increasing request for skin rejuvenation above the knee, very few treatment options have been reported in literature. To evaluate the efficacy and safety of 1:4 hyperdiluted calcium hydroxylapatite (CaHA) in the treatment of skin laxity and dimples of the skin above the knees. A retrospective evaluation of hyperdiluted CaHA treatment for skin laxity and dimples above the knee was performed. Efficacy was classified as blinded evaluation of pre (T0) and 3-month post-treatment (T1) photographs by three investigators according to the validated knee cellulite severity score (KCSS) and patient satisfaction. Safety was evaluated through pain scores and adverse events evaluation. A significant reduction of KCSS at T1, as compared to T0, mainly in subjects with lower KCSS at T0, was observed (P <.05). All blinded assessments resulted in a correct identification of T0 and T1 pictures and evaluations of all investigators were found to be consistent and reliable. All patients were satisfied. Only minor adverse events (swelling, erythema, bruising, and skin irregularities) were reported, lasting 2 to 3 weeks after treatment. Our preliminary results highlight the efficacy and safety of hyperdiluted CaHA in the treatment of skin laxity and cellulite above the knees.

Original languageEnglish
Article numbere14076
JournalDermatologic Therapy
Issue number6
Publication statusPublished - Nov 1 2020


  • calcium hydroxylapatite
  • cellulite
  • hyperdiluted calcium hydroxylapatite
  • hyperdilution
  • knees
  • skin laxity

ASJC Scopus subject areas

  • Dermatology


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