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Aesthetic Medicine – New biorestructuring materials: tricalcium phosphate

Preview of the publication of the book about filler
edited by Professor Pasquale Motolese.
Redaelli Alessio
July 2007

Introduction

Among the many biorestructuring materials that provoke an action of neocollagenesis, tricalcium
phosphate represents interesting news.
The origin is determined by ceramics, which are non-metallic and non-organic materials.
It is a product that is already packed, ready to use and do not require, as many other fillers, an
allergic test or a dilution before the use.
Indeed, tricalcium phosphate for cosmetic use is not in aqueous suspension as the polylactic acid, but
is dispersed in hyaluronic acid.
So it conjugates the restructuring effect typical of these materials, and the immediate filling effect
given by hyaluronic acid.
Materials: tricalcium phosphate and hyaluronic acid
Tricalcium phosphate, whose chemical formula is Ca10(PO4)6(OH)2, belongs to the large category of
synthetic bioresorbable ceramics.
Hydroxyapatite also belongs to this category of products, but surely there are significant differences
between the materials, first the disappearance from the tissues, which is much faster in the case of
tricalcium phosphate.
The product is obviously chemically inert, bioresorbable and biocompatible.
Tricalcium phosphate particles have an average diameter of 40 Micron.
Once implanted, the tricalcium phosphate is phagocytosed by macrophages and slowly degraded by
hydration in calcium and phosphorus ions.
The sodium hyaluronate is present in all living organisms in the intercellular matrix, in synovial fluid
and cartilage.
The one used in the gel in combination with tricalcium phosphate has a molecular weight between 2
and 3 million Dalton.

Injective Technique

The injective technique, although still limited, is the actual experience of users, based on two effects
of preparation: the filler effect of hyaluronic acid and the effect of neocollagenesis given by tricalcium
phosphate.
So it is a product that has to be used deeply, subdermal, but also exploiting this immediate filler effect
that allows us to give visible result immediately.
The best districts are definitely the cheekbones and the nasogenian furrows, but also the mandibular
edge and the area of the cheeks that respond very well to the product.
According to the author’s opinion, the mimic zones with thin skin are less indicated.
In aesthetic field, there is still not experience in other body districts.
The technique is always the retrograde tunneling, taking care to deposit small quantities of material at
the time; it is better if you do so in the deep derma.
You have to pay attention, for the first times, to the easiness of the injection.
In fact, the product is very soft and this results in an absolute ease of installation.
Instead, any overdosage has to be avoided, and the advice is to run the following sessions avoiding
using too much material at a time.
Between the sessions it is better to wait a reasonable period of time to allow the manifestation of
neocollagenesis due to tricalcium phosphate, generally about a month.
However, even the injective technique is still in progress, and further improvements are soon to come.

RESULTS

It is still too early to give results at long distance, but preliminary results are good and the author has
not found the occurrence of major side effects
The great easiness of the injection and the good immediate aesthetic results have to be highlighted.
Conclusions
Tricalcium phosphate in gel made of hyaluronic acid represents an interesting and innovative alliance,
which allows conjugating an immediate filler effect with the biorestructuring effect of tricalcium
phosphate that instead develops more slowly reminding us other materials of this type.
The preliminary results are good, but it is necessary to wait for further confirmations especially to
evaluate possible long distance collateral effects and the duration of the result.
Up to now, the bibliography about the cosmetic use of tricalcium phosphate on human being is still
scarce.

BIBLIOGRAPHY
• Cameron H.: Evaluation of a biodegradable ceramic, J Biomed Mat Res, 1977, 11, 179.17
• Eghtedari M.: B-tricalcium Phosphate Granules as an alternative material for ocular
implantation. IJMS Vol.31, n°3, September 2006
• Hassler CR: Long term implants of solid tricalcium phosphate. Proc. 27th Ann.Conf.Eng.Bio.,
16, 488,1974
• Monroe E, New calcium phosphate ceramic material for bone and tooth implants, J Dent Res
1971 Jul, 50(4), 860-861
• Van der Meulen: Inflammatory response and degradation of three types of calcium Phosphate
ceramic in non osseous environment. J Biomed mater Res. 1999 Jan; 44(1): 78-86

Informed Consent – Tricalcium Phosphate ATLEAN