# Facial Skin Revitalization With CPM‐HA20G (Hyaluronic Acid + Glycerol): A Comparative Case Series Using Three Delivery Techniques With Ultrasound Confirmation

## TL;DR

This study compares three methods of delivering a skin booster (CPM-HA20G) and finds they all improve skin quality, with one method causing less pain and fewer side effects.

## Contribution

The first prospective comparative evaluation of CPM-HA20G delivery methods with ultrasound confirmation of product placement.

## Key findings

- All three delivery methods improved skin elasticity, firmness, and hydration equally.
- Blunt cannula delivery caused significantly less pain and fewer bruises than the other methods.
- High patient satisfaction was reported across all treatment methods.

## Abstract

Skin boosters are commonly administered into the dermis or immediate subdermal plane using serial puncture technique. Alternative delivery methods, such as blunt cannulas and multiple‐needle injector devices, are available, but their ability to achieve comparable clinical outcomes has been under‐investigated. This case series presents the first prospective comparative evaluation of CPM‐HA20G administered via three different modalities, assessing efficacy, safety, and adverse events, while utilizing ultrasound to confirm product placement. To minimize patient‐related variability, a split‐face study design was also employed.

To demonstrate the efficacy, safety, and comparability of results when delivering CPM‐HA20G via multiple modalities into the immediate subdermal plane.

Fifteen patients received three treatments of CPM‐HA20G, four weeks apart, using serial puncture, blunt cannula, and multiple‐needle injector device. A separate split‐face case compared serial puncture with blunt cannula delivery in the same patient, with ultrasound confirmation of product placement. Satisfaction rates, pain scores, and skin quality were assessed at 4, 8, and 12 weeks.

All 15 patients across the three modalities achieved comparable improvements in skin elasticity, firmness, and hydration. High patient satisfaction was reported, with no serious adverse effects observed. A paired t‐test showed pain scores were significantly lower with blunt cannula (mean 2.2) compared with serial puncture (mean 4.6) and injector device (mean 4.5) (
p < 0.0001). Blunt cannula delivery was also associated with a lower incidence of bruising, suggesting clinical advantages for patient comfort and recovery.

This case series demonstrates that serial puncture technique, blunt cannula and multiple‐needle injector device can be used to deliver safe, comparable, and effective CPM‐HA20G treatments. These findings highlight comparable efficacy across modalities and suggest blunt‐cannula delivery enhances patient comfort and recovery time.