Gel first, collagen after
Radiesse is made by Merz. It is calcium hydroxylapatite, or CaHA, in the form of microspheres of 25 to 45 µm. These make up about 30% of the syringe, in about 70% gel carrier. Radiesse (+) has lidocaine added. In Chinese it is known as 微晶瓷.
The gel gives some volume on the day. In the following weeks, fibroblasts lay down collagen around the microspheres, and that collagen carries the change once the gel has been absorbed. The body metabolises the microspheres gradually into calcium and phosphate, so the change does not last for life. Results vary.
The US FDA approved Radiesse in December 2006 for HIV-associated facial lipoatrophy and moderate-to-severe facial folds. Later approvals covered the hands and, for Radiesse (+), the jawline. Diluted use draws on a 2019 international consensus on ratios and depths.
Two ways Radiesse treatment is used in Singapore
A structural use. Small amounts go deep at the chin, jawline, pre-jowl area and backs of the hands.
Mixed with saline and lidocaine and placed shallow, often by cannula. It is used for firmness and texture on the neck, chest, arms, abdomen, thighs, buttocks and hands. It adds almost no volume, and change comes gradually.
Diluted Radiesse can sit under a rolling scar after subcision, keeping the released space open while collagen forms. It is not used for ice-pick or boxcar scars.
Who it may suit
It may suit you if you need structural support in firm tissue, such as the chin, jawline, outer cheek or hands. Diluted use may suit crepey or loose skin on the neck, chest, arms, abdomen and hands, if you accept that change is slow and that this is not a volume treatment. In both cases you need to be comfortable that it cannot be reversed. If you have never been assessed, a reversible hyaluronic acid filler is a more forgiving place to start.
Who should avoid it or wait
A history of anaphylaxis or several severe allergies. Known allergy to CaHA, its components or, for Radiesse (+), lidocaine. Bleeding disorders.
Pregnancy or breastfeeding, as safety has not been established. Infection or inflammation at the site, including active acne or a cold sore.
Autoimmune disease or immunosuppressive treatment. Keloid or hypertrophic scarring, considered case by case. Blood thinners, which mean more bruising. Recent or planned dental work.
It is not injected over non-absorbable filler such as silicone. Filler of unknown type is scanned first.
What Radiesse cannot do
Hyaluronidase acts only on hyaluronic acid, so it will not dissolve Radiesse. A misplaced result has to be managed. Radiesse does not lift a descended jowl or loose jawline, and volume placed below a jowl can make it look heavier. For laxity the doctor may discuss focused ultrasound or the 4K Body Lift. It is not used in lips, tear troughs or the glabella, where a reversible hyaluronic acid product is chosen. Diluted use adds no real volume. It does not treat hanging skin, pigment or veins on the hands.
Scans, and what to tell us first
Radiesse is radio-opaque. It can be seen on X-ray, CT and ultrasound. Tell your radiologist and dentist that you have had it. Before your visit, declare all earlier fillers, pregnancy, breastfeeding, autoimmune conditions, keloid history and blood thinners. Avoid fresh sun exposure, and pause strong skincare actives as advised.
Side effects and risks
Swelling, bruising, tenderness, and short-lived firmness where undiluted product sits.
Nodules, or product you can see or feel, from shallow placement. Diluted use in thin skin can leave unevenness or small nodules.
Vascular problems, as with any injectable near facial vessels. Depth and anatomy matter most.
Red, hot, painful or swollen lump: see a doctor the same day, or A&E if none is available. Pale, dusky or mottled skin, or worsening pain: get urgent assessment now from your injecting doctor or A&E. Change in vision or eye pain: call 995 now. More in our warning signs guide.
Lumps and corrections
Lumps and heaviness after earlier filler are usually dealt with by taking product away, not by adding more. Ultrasound comes first. Nodules can be treated without surgery, including with the Sculpting mode of Time Freeze Laser LCLR. A medical injection that can degrade CaHA nodules has also been reported. It is a management option, not routine care and not a true reversal. See our page on pillow face for more on excess filler.
Recovery, in phases
How long it lasts, and how fees work
No duration is promised. It depends on dilution, area, amount, your tissue and any weight change. Review timing is set at consultation. Fees are not published. They depend on undiluted or diluted use, the areas, the amount and dilution needed, staging, and any combined treatment. A written quote comes at consultation, along with a plan that includes the option of no treatment.