Written by Karen Vieira, PhD MSM
What is Radiesse?
Radiesse (formerly marketed as “Radiance”) is an injectable cosmetic filler that was FDA approved to treat deep facial wrinkles, lines, or folds. It works by improving the structure of the skin from the inside, through stimulating your body’s production of collagen.
Collagen is a key structural element of the skin, giving skin its youthful volume, suppleness, and tightness. Collagen is lost as part of the natural aging process, causing the skin to sag and develop lines and wrinkles.
By restoring collagen, Radiesse is able to improve the appearance of skin, and reduce facial lines and wrinkles.
Areas commonly treated
Some of the more common uses of Radiesse include:
- Adding volume to sunken temples
- Non-surgical nose reshaping
- Lifting, volumizing, and contouring cheeks
- Smoothing nasolabial folds (the “smile lines” running from the nose to the corners of the mouth)
- Defining and shaping the jawline
- Smoothing marionette lines (the long vertical lines around the mouth and chin)
- Volumizing jowls
- Volumizing sunken areas on the back of the hands
However, Radiesse can be used “off label” (without FDA approval) virtually anywhere on the body, and guidelines exist for its use in the face, neck and décolletage, thighs, buttocks, abdomen, knees, arms, hands, and even the elbows.
How does it work?
Radiesse is unlike most other dermal fillers because it is made from calcium hydroxylapatite (CaHA), a natural compound found throughout the body. Radiesse works by stimulating natural collagen production, which provides the skin with the support and lift it needs to reduce lines and wrinkles.
Once injected, Radiesse provides immediate volume correction, but its most potent effect develops over time. Over time, the carrier gel in Radiesse is absorbed, leaving just the tiny CaHA particles. Collagen forms around each sphere, increasing the volume of the targeted area.
As such, Radiesse’s true value is in its effects as a biostimulatory agent that helps the body to produce its own skin rejuvenation effects. This stimulation of natural collagen production has been shown in clinical studies to continue 9 months after the Radiesse injection, accompanied by ongoing improvements in cosmetic effects.
A Radiesse treatment usually takes about 30 minutes as an office procedure. Your healthcare professional may apply topical anesthetic immediately before the injection to minimize any discomfort. Then, Radiesse is injected through a tiny needle into the targeted area of skin. Several injections may be required depending on the size of the treatment area and the desired result. After the procedure you are free to leave the doctor’s office immediately.
People who undergo Radiesse injections often require no downtime and can return to work and other daily activities immediately. Some precautions are necessary after treatment, such as avoiding strenuous activity and extensive sun or heat exposure for about 24 hours or until any swelling or redness has resolved.
When will you see results?
Most patients will see visible results within 7-10 days of treatment.
How long does Radiesse last?
The ingredients of Radiesse are not easily broken down by the body. As a result, this is one of the longest-lasting injectable fillers currently on the market.
Medical studies using MRI imaging techniques have demonstrated that Radiesse produces a long-lasting dense matrix of collagen, supporting improved mechanical properties of the skin. On average, results can last between 9-15 months.
Calcium hydroxylapatite has been around for awhile, so there is a lot of data and experience to support its safety and effectiveness but it is not without potential risks.
Redness, swelling, and bruising may occur after injection, although these side effects usually subside after a few days but can last up to a week. Pain and itching at the injection site may also occur.
There is also the risk of nodule formation, in which hard lumps form under the skin. This complication may be treated through surgery or steroids.
Unlike other fillers, Radiesse is composed of Calcium hydroxyapatite which cannot be dissolved and is therefore not reversible. It could possibly be removed through surgery but you would need to be examined by a healthcare professional.
Cost of Radiesse
The primary factor that determines the cost of Radiesse is how many syringes you need. The average cost of Radiesse is about $600 to $800 per syringe with either one or two syringes required per treatment session. On average, a typical treatment session costs between $900 to $1500.
Your healthcare professional will determine the volume needed to achieve the desired result. While this is higher than the cost of some other dermal fillers, the results last longer so patients require less frequent treatment to maintain results.
While the costs of cosmetic procedures like this are not usually covered by health insurance, many healthcare professionals offer financing plans to make the treatment more affordable.
Comparing CaHA vs. HA fillers
Hyaluronic acid (HA) fillers (such as Juvéderm, Restylane and Belotero) and CaHA fillers like Radiesse are both FDA approved for treating various problem areas around the face. Although they have similar uses, they are different compounds with different modes of action, and there are some notable differences between the two products.
One study demonstrated a higher-level of patient satisfaction, efficacy and duration of correction with Radiesse compared with two HA fillers. Another study showed about 40% improvement of marionette lines 30 months after the last treatment.
Radiesse is particularly effective for deep lines (such as marionette lines and nasolabial folds) and for filling large areas (such as the cheeks), because of its pronounced volumizing effect.
There are a couple of drawbacks to Radiesse compared to HA fillers. After a few months, when the gel carrier of Radiesse is absorbed by the body, some people may notice a slight decrease in the volume in the treated area. However, this tends to be compensated by the ongoing production of collagen.
As well, if any unsightly side effects occur, such as lumps under the skin, HA can be fully reversed, whereas Radiesse cannot. Because of this, you will have to wait until the results wear off naturally if you are unhappy with the treatment. That being said, one study of 609 people who received Radiesse treatments showed that 89% of them would use Radiesse again.
Tips for selecting a provider
For the best results, it’s recommend that you choose a qualified provider to ensure a safe procedure and natural-looking results. The following are a few tips to help you find the best provider:
- Select a board-certified plastic surgeon or dermatologist
- View their before and after photos of Radiesse patients
- Read online patient reviews about the provider
- Bader, R.S. (2018). Dermal fillers. Medscape Dermatology.
- de Almeida, A., Figueredo, V., da Cunha, A., Casabona, G., Costa de Faria, J. R., Alves, E., et al. (2019). Consensus recommendations for the use of hyperdiluted calcium hydroxyapatite (Radiesse) as a face and body biostimulatory agent. Plastic and Reconstructive Surgery, 7(3), e2160. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467620/
- Emer, J., & Sundaram, H. (2013). Aesthetic applications of calcium hydroxylapatite volumizing filler: An evidence-based review and discussion of current concepts: (Part 1 of 2). Journal of Drugs in Dermatology, 12(12), 1345
- Food and Drug Administration (FDA). (2006). Radiesse. Retrieved from https://www.accessdata.fda.gov/cdrh_docs/pdf5/p050037c.pdf
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- Jacovella, P.F. (2008). Use of calcium hydroxylapatite (Radiesse) for facial augmentation. Clinical interventions in aging, 3(1), 161-74.
- Mowlds, D.S., & Lambros, V. (2018). Cheek volumization and the nasolabial fold. Plastic and Reconstructive Surgery, 141(5), 1124-1129. DOI: 10.1097/PRS.0000000000004341
- Yutskovskaya, Y., Kogan, E., & Leshunov, E. (2014). A randomized, split-face, histomorphologic study comparing a volumetric calcium hydroxylapatite and a hyaluronic acid-based dermal filler. Journal of Drugs in Dermatology, 13(9),1047-52. Retrieved from https://jddonline.com/articles/dermatology/S1545961614P1047X/