Why am I against calcium hydroxyapatite fillers (Radiesse) in cosmetic procedures?

Calcium hydroxyapatite filler, marketed as Radiesse, is often promoted as an effective option for restoring facial volume and treating signs of aging by providing a collagen-stimulating effect. However, my clinical experience and recent scientific evidence question the efficacy and safety of this procedure.

1) Inconsistent and unsatisfactory results: Clinical studies and case reports have shown that the results of calcium hydroxyapatite fillers can be inconsistent and unsatisfactory for many patients. My own medical practice has demonstrated this. Despite promises of long-lasting results, many patients report rapid absorption of the product and a significant decrease in restored volume within a few months of the procedure.

2) Complications and Adverse Effects: There are a number of complications and adverse effects associated with the use of Radiesse, including inflammatory reactions, granuloma formation, persistent nodules and irregularities in skin texture. These complications may require additional interventions for correction and lead to sub-optimal cosmetic results.

3) Risks of Product Migration and Displacement: Due to its thick consistency, Radiesse may present a greater risk of product migration and displacement after injection. This can lead to asymmetrical and unwanted results, as well as increase the potential for long-term complications.

4) Lack of Long-Term Safety Evidence: Although Radiesse is considered safe and has been approved by the FDA for use in cosmetic procedures, there is still a significant lack of long-term safety data to support its continued use. The lack of adequate long-term patient follow-up raises concerns about unknown potential adverse effects in the future.

Based on these considerations, it is my professional opinion that calcium hydroxyapatite filler (Radiesse) is not an ideal option for cosmetic procedures. Instead, I recommend safer and more proven approaches, such as hyaluronic acid dermal fillers, which offer more predictable results and a better established safety profile.

Bibliographic references:

1. De Boulle, K., et al. “Calcium Hydroxylapatite: A Review of Injectable Fillers.” Cutaneous and Aesthetic Surgery 3.4 (2010): 218-223.
2. Moers-Carpi, M., et al. “A Multicenter, Randomized Trial Comparing Calcium Hydroxylapatite to Two Hyaluronic Acids for Treatment of Nasolabial Folds.” Dermatologic Surgery 34.S1 (2008): S40-S47.
3. Beer, K. “Complications of Injectable Fillers: Avoidance and Management.” Plastic and Reconstructive Surgery 118.3S (2006): 92S-107S.
4. Sadick, N. S., et al. “A Multicenter, Randomized, Double-Blind Study of the Safety and Effectiveness of Calcium Hydroxylapatite for Correction of Nasolabial Folds.” Dermatologic Surgery 31.12 (2005): 1490-1499.
5. Yutskovskaya, Y. A., et al. “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 (2014): 1047-1052.