Radiesse is the only filler offered at Nuance Facial Plastics that is not based on hyaluronic acid.  It instead is made our of calcium hydroxyapatite, which is the same material found in bones, but is supplied in a gel form so it can be injected.  It is by far the stiffest of the injectable fillers, and this property gives it a unique place in our practice.  While I prefer to use Restylane Lyft and Juvederm Voluma to restore lost facial fat, Radiesse works best to “build out” the mid face.  Since it mimics bone, I use a deep injection technique, laying the material down as close to the bone as I can, and can sculpt the bones of the face this way.  Its ability to “build” high cheekbones in people that do not have them naturally puts this filler in its own category, and also makes it my preferred filler for facial feminization patients, as I can essentially sculpt the facial bones using injections alone with instant results.  As it is not based on hyaluronic acid, it is not a reversible filler (that can be “melted” with an injection of an enzyme), so extra care must be taken when injecting it.  

 

 

The combination of Radiesse with Restylane Lyft is my preferred way to augment the midface, as “the foundation” (bone) is built out using Radiesse, and a softer filler like Restylane Lyft is used to restore the soft tissues of the cheeks.  Having fillers of varying thickness and stiffness is a powerful tool, and using multiple lines of fillers and having experience with using them together gives even better results.

 

 

Radiesse in the midface lasts between 9 months and 1 year, though there is quite a range of duration based on the area injected and the individual.  When used in areas with more motion, it does not last quite as long compared to areas with less movement.

 

 

No.  I have seen this done by other providers with some unfortunate results.  Radiesse is great in the cheeks, but the tear troughs require something softer, and reversible, as lumps can form, and the ability to dissolve them makes Restylane the winner in this area at Nuance Facial Plastics.

 

 

Radiesse is supplied in 1.5cc syringes, so you get more augmentation with a single syringe compared to any other filler offered at Nuance Facial Plastics.  It is not a completely fair comparison, however, because a part of the Radiesse is the carrier gel, which is absorbed by the body, leaving the calcium hydroxyapatite behind.  Do you get more than a syringe of Restylane?  Yes, but not exactly 1.5x more.