Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage

J Cosmet Dermatol. 2018 Feb;17(1):66-72. doi: 10.1111/jocd.12475. Epub 2017 Dec 29.


Background: Skin laxity and wrinkling on the neck and décolletage reveal age as reliably as the face.

Objective: To evaluate the combined use of microfocused ultrasound with visualization (MFU-V; Ultherapy® ) and diluted calcium hydroxylapatite (CaHA; Radiesse® ) for treating the neck and décolletage.

Methods: Subjects with moderate-to-severe lines on the neck and/or décolletage were retrospectively enrolled. MFU-V was applied using 7 and 10 MHz transducers followed by subdermal injection of CaHA diluted 1:1 with lidocaine solution. Photographs at baseline and 90 days were assessed by two independent, blinded evaluators using three scales: Merz Aesthetics décolleté wrinkles, Fabi-Bolton chest wrinkle, and Allergan transverse neck lines scales.

Results: A total of 47 subjects were treated as follows: 29 (neck only), five (décolletage only), and 13 (both areas). Mean neckline score improved from 2.6 (moderate-to-severe lines) at baseline to 1.3 (mild lines) 90 days after treatment (P < .001). Mean décolletage scores improved from 2.6 and 3.3 (moderate-to-severe wrinkles) on the Merz Aesthetics and Fabi-Bolton scales, respectively, to 1.1 and 1.8 (mild wrinkles), respectively, after treatment (both P < .001). Both procedures were well tolerated with high subject satisfaction.

Conclusions: Combining MFU-V with 1:1 diluted CaHA is effective for improving the appearance of neck and décolletage lines and wrinkles.

Keywords: calcium hydroxylapatite; décolletage; esthetic medicine; microfocused ultrasound; neck; skin laxity.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Combined Modality Therapy
  • Durapatite / administration & dosage*
  • Esthetics
  • Female
  • Humans
  • Injections, Intradermal
  • Male
  • Middle Aged
  • Neck
  • Patient Satisfaction / statistics & numerical data*
  • Photography
  • Rejuvenation / physiology*
  • Retrospective Studies
  • Risk Assessment
  • Skin Aging / physiology*
  • Statistics, Nonparametric
  • Thorax
  • Treatment Outcome
  • Ultrasonic Therapy / methods*


  • Durapatite