Use of calcium hydroxylapatite (Radiesse) for facial augmentation

Abstract

Radiesse (Bioform Inc, USA) is a sterile, latex-free, non-pyrogenic, semi-solid, cohesive subdermal, injectable implant, whose principal component is synthetic calcium hydroxylapatite, a biocompatible material with over 20 years of use in medicine. The semi-solid nature of the product is created by suspending calcium hydroxylapatite microspheres of 25-45 microns diameter in a gel carrier of carboxymethylcellulose. The product has FDA approval for esthetic facial augmentation in the US. Such approval includes the long-lasting correction of moderate to severe facial wrinkles and folds and the treatment of facial fat loss due to immunodeficiency virus infection. Diverse facial regions can be injected in order to ameliorate or enhance some features: glabellar lines, subdermal support of the brows, malar and buccal fat pads, tear troughs, nasolabial folds, nose, lips, perioral region, marionette lines, oral commisures and chin among others, as well as saucerized acne scars. Other medical indications include nipple projection for nipple areolar reconstruction, urinary incontinence, vesicoureteral reflux, vocal cord augmentation, and use as a radiographic tissue marker. The average lasting result is from 12 to 18 months. Radiesse can be considered an effective soft-tissue filler for overall longevity, biocompatibility, and low rate of side effects.

Figure 1

Pre-treatment (A) and post-treatment (B) at 9 months after 0.5 mL of Radiesse, in a 65-year-old woman with two static vertical glabellar lines.

Figure 2

Pre-treatment (A) and post-treatment (B) at 18-month follow up of a 44-year-old woman with sunken upper maxillary anatomical region. The implant of 1.5 mL of Radiesse provided an enhanced infra-orbital area. The patient was injected by Dr. Miles Graivier.

Figure 3

Pre-treatment (left) and post-treatment (right) at a 12-month follow up, in a profile view of a 42-year-old woman with a primary aesthetic rhinoplasty. Enhancement of tip projection was achieved with 0.5 mL. No touch-up was necessary after first implant.

Figure 4

Pre-treatment (left) and post-treatment (right) at a 12-month follow up, in ¾ view of the same patient as in Figure 3.

Figure 5

Pre-treatment (A) and post-treatment (B) of a 52-year-old woman with noticeable nasolabial folds. After 0.5 mL in each side and a touch-up at 3 months, the results are shown after a 12-month follow up period. The total amount in each side was 0.8 mL.

Figure 6

Pre-treatment (A) and post-treatment (B) of the same patient as in Figure 5, in ¾ view.

Figure 7

Pre-treatment (A), immediate at 24 hours post-treatment (B), after 15 days (C), and at 12 months post-treatment (D) of a 68-year-old woman. The total amounts were 0.7 mL for the upper lip and 0.5 mL for the lower lip. No touch-ups were performed after first injection.

Figure 8

Pre-treatment (A) and post-treatment (B) of the previous patient in a ¾ view. Despite a previous lip asymmetry, a total amount of 1.2 mL of Radiesse in both lips provided enhancement and projection of vermilion border and filtrum. Radial lip lines were lessened.