Dr. Weiner performing Liquid Facelift with Radiesse and Belotero

Q: Restylane Vs Radiesse for Cheek Enhancement?

A: For cheek enhancement, Radiesse will last a little longer than Restylane

Radiesse is the highest G prime filler on the market.  This is a measure of lifting ability.  It will last anywhere from 12-18 mos in most people.  Restylane is a little softer with less swelling and slightly less G prime.  Both are good choices.  More important than the filler is the “filler” you choose.  The results depend on the injector for the most part.

Q: Is It Possible to Combine Radiesse and Joliderm?

A: Juvederm and Radiesse can be used in same area

If you get one filler like Radiesse and want to get more filler, it’s ok to use any filler on top of that filler. There is no interaction between the 2. If you’ve done Radiesse first, it has swelling which can persist for 4-5 days so wait for that to calm down before adding more. I typically wait about 10 days before I will inject more filler in someone.  In the video, you can see using Belotero and Radiesse in similar areas.  Steve Weiner, MD , Facial Plastic Surgeon, Destin, Florida.

Q: 5years Ago I Had Radiesse Filler Injected into my Lips. 4 Years Later my Lips Have Hard Bumps?

A: Radiesse is not a lip filler because you get long term nodules

Radiesse has been a problem for people who got their lips injected.  It creates the problem you describe, hard nodules in the lips.  These need to be excised to improve.  Radiesse is a great filler though, but not for the tear trough and lips.  See my liquid facelift video with Radiesse.  Steve Weiner, MD, Destin, Florida.

Q: I Have a Ridge After Radiesse!! What is It? and How Can I Make It Disappear? (photo)

A: Ridge after Radiesse in orbital rim area, try injecting saline with lidocaine to mechanically break up

I have some success with the very few episodes of Radiesse clumping by using a combination of Lidocaine and saline in the area. I vigorously move the needle in and out to try to break up the area. I has worked in all my cases. No other solutions other than cutting it out or camouflaging with another filler like Restylane. See my videos of using blunt cannulas with Radiesse in this area. Steve Weiner, MD, Destin and Panama City Beach, FL.

Q: Tear troughs to be injected with radiesse by occuloplastic surgeon?

A: Radiesse in tear troughs, not recommended.

Radiesse is a thick filler and will tend to show in the thin skin around the eye. It’s great for filling the cheek, but not the area which is close to the eye. It also has a tendency to clump. So for tear troughs, Restylane or Belotero are the fillers I use. Also, to minimize downtime and the chance of bruising, I suggest using blunt cannulas for this treatment. Steve Weiner, MD, Facial Plastic Surgeon, Destin, Panama City, Florida.

Q: I got radiesse injections in my cheeks 6 days ago. Swelling progressively getting worse. What should I do? (photo)

A: The swelling you have after Radiesse is too much

You should see someone.  Swelling does occur after Radiesse, but not to the extent you have and usually subsides in 3-4 days.  Either it’s infected or you have an angioedema.  Either way, see someone ASAP.  My video shows a liquid facelift using Radiesse.  Steve Weiner, MD, Facial Plastics.

Q: Is It Possible to Combine Radiesse and Joliderm?

A: Juvederm and Radiesse can be used in same area

If you get one filler like Radiesse and want to get more filler, it’s ok to use any filler on top of that filler. There is no interaction between the 2. If you’ve done Radiesse first, it has swelling which can persist for 4-5 days so wait for that to calm down before adding more. I typically wait about 10 days before I will inject more filler in someone.  In the video, you can see using Belotero and Radiesse in similar areas.  Steve Weiner, MD , Facial Plastic Surgeon, Destin, Florida.

Q: Getting Radiesse a Month Before Engagement Pary in May, Will I Recover In Time?

A: Recovery from Radiesse should be very quick, especially if you have it injected with blunt cannulas

Radiesse has a characteristic swelling for a few days after injection.  There is nothing that can be done to combat that.  However to get the fastest recovery, use blunt cannulas so there is minimal bruising and less swelling.  You can see the video attached in which I injected about 8 syringes of Radiesse plus about 3 of Belotero (a liquid facelift) and then she left to go to work.  The only bruising she had was from the Belotero which was injected with a needle for the very superficial fine lip lines.  Steve Weiner, MD, Between Destin and Panama City Beach, Florida.

Q: Is 25 Years Old Too Young to Be Considering Radiesse Injections for Minor Nasolabial Folds? (photo)

A: Radiesse for a 25 year old nasolabial folds is quite alright

There really is no age limit as to when to get fillers.  If you have a concern about your nasolabial folds then try some fillers.  If you don’t like them, after about a year, you are back to where you started plus one year of aging.

Q: How to Get Rid of a Botelero (Fille) Ridge Lump?

A: Belotero is a hyaluronic acid so it can be dissolved with hyaluronidase

It would be unusual to have bumps from Belotero because its properties cause it to integrate with the skin and become rather smooth.  However, it you do have ridges, the first thing would be massaging the area.  If this weren’t to work, than hyaluronidase will work fine.  Lasers don’t dissolve filler.

Q: Will Radiesse Help Achieve Sculpted Cheek and Eliminate Slight Jowl?

A: Radiesse is an excellent choice to help lift cheek and fill pre-jowl sulcus

I like Radiesse for those purposes.  Radiesse has the highest G prime of all fillers which means it has the greatest lifting ability.  You will need at least 2, maybe 3 syringes to get the improvement.  See my video which goes over the liquid facelift which includes these areas with Radiesse.

Q: Is There a Way to Remove Lumpy Radiesse Be Removed from Tear Trough?

A: Radiesse in the tear trough – shouldn’t be done

The tear trough is very thin skin and you need a thin filler like Restylane or Belotero for that area.  Hopefully after 2 weeks it will not be noticeable.  It tends to swell for about 3 days so don’t be concerned at this point.  If it’s still a problem at 2 weeks, try some saline to break it up.  If that doesn’t work, it’s either time or surgical removal.  Watch my video for injecting all over the face with Radiesse and Belotero…so called liquid facelift.  Steve Weiner, MD, Destin, Florida.

Q: Do You Recommend Radiesse in One Cheek? (photo)

A: I’m 50:50 on this one. Right cheek looks too big, do you add to left to make symmetric?

I can see your problem from the pictures.  Do you overfill both sides to get symmetric?  If you wanted to see how it would look, I’d go with Perlane or Restylane, so it can be erased with hyaluronidase if you don’t like it.   Video shows cheek injection with Restylane.  Steve Weiner, MD Facial Plastic Surgeon, Destin, Florida

Q: Am I a Good Candidate for Chinn and Cheeekbone Enhancements with Radiesse? (photo)

A: Radiesse is great for chin and cheek enhancement

Radiesse is a very hardy filler, great for creating “pseudo implants” in the cheeks and chin area.  If cannulas are used, bruising and swelling should be minimized.  See my video which uses Radiesse all over the face.  Steve Weiner, MD, Facial Plastic Surgeon, Panama City Beach, Florida.

Q: Radiesse 1st Treatment Scheduled, Concerns & Questions

A: Questions when rushing for a Cosmetic Procedure discount.

When you see a 50% off discount for a cosmetic procedure, please evaluate the situation before rushing to get it done.  What are the qualifications of the Doctor?  Is the Doctor doing the procedure?  Have your friends seen this Doctor?  What are the Doctor’s reviews? What’s the Doctors experience with fillers and Radiesse.  Sometimes this is a perfectly legit way to try to expand one’s business but most of the time it’s a non Plastic or non Facial Plastic Surgeon or non Derm that is trying to undercut because he/she is trying to get into the business.  Blunt cannulas are the way to go with the Radiesse for less bruising, less swelling, and less discomfort.  There are no knock offs for Radiesse.  There is a little more swelling with Radiesse than the other fillers like Restylane or Perlane and it’s not reversable like the HA fillers..something to keep in mind.  See my video.  Steve Weiner, MD

Q: No Improvement After Initial Radiesse Injections?

A: Flat cheeks not improved with Radiesse…you just need more

Radiesse is a filler that you don’t want to do too much in one treatment in the upper cheeks.  Waiting a month for putting more in is appropriate.  I don’t think that the other fillers are any better than Radiesse for the cheeks so I would go with the game plan your PS has laid out.

Q: Does Radiesse Cause Serious Diseases Such As Cancer?

A: Radiesse is made of Calcium Hydroxylapatite which is a naturally occurring substance

Radiesse is made of Calcium Hydroxylapatite which is found in bone and joints.  It is great for volumizing, where there is large deficits, because it corrects about one and a half to one when compared to the HA fillers.  I does not cause any types of cancers.

Q: Complications from Radiesse Rec’d 6 Wks Ago?

A: Painful nodules soon after Radiesse injections – sounds like infection

You are not describing a normal reaction to Radiesse.  Your symptoms seem like there is an infection going on and should not be left untreated.  Unfortunately, Radiesse can’t be dissolved like HA fillers so you have to aggressive antibiotics.  It might need to be removed surgically if the infection can’t be cleared.  This is a very rare problem.  It is imperative that the physician use aseptic technique when adding lidocaine and during the injection as well as proper skin cleansing.

Q: Radiesse Injection Went Bad?

A: Problems after Radiesse injection – call you doctor ASAP

What you are describing is not normal after having Radiesse.  My patients have almost no swelling at day 4.  Having pus is very concerning.  Very rarely is there an infection after injections but obviously you have one.  Hopefully a fully trained physician performed you procedures and you can get help.  Could it be viral?-yes, herpes can be stimulated from the injection, but for anyone at risk for this, I put on preventative doses of Valtrex.  I have also seen agioedema after filler injections which this might be, but unlikely

Q: Lingering Numbness and Vision Problems After Radiesse?

A: Visual changes and numbness after Radiesse; you need an expert opinion

You sypmtoms are not normal.  I’d see an Ophthalmologist ASAP.  It sounds like the infraorbital nerve is bruised and possibly the vessels near it were injected.  This is not something that can wait.  All numbing from injection should be out of your system already.  If an Ophthalmologist clears you, I’d feel much better.

Q: I Want my Face to Look Fatter and Rounder. It’s Long and Skinny, What Can I Do?

A: A rounded face is more youthful than a long and narrow face. Sculptra is your best choice

You hit the nail on the head.  As we age your fat pads, bones, jaw, and muscles in the face all atrophy.  This creates a longer and skinnier face which ages us.  To recreate the more rounded appearance of a youthful face, fillers are the answer.  Sculptra is great for this because it is a long last volumizer, which can be injected in multiple areas such as the temples, preauricular area, upper and lower cheek, jawline, and marionette area.  I can’t be used too close to the eyes or mouth area because of nodule formation, and that is where an HA filler is good.  Can this all be done with Radiesse or Restylane?  Yes, but the expense would be much more than Sculptra, and the duration would be less.

Q: Radiesse on Actual Cheekbone? (photo)

A: Radiesse for volumizing face is a good choice

In answer to your question, it’s not uncommon to place radiesse deeply, even at the level of the cheek bone.  However, i think that the majority of your problem with volume is in the lower cheek area.  This area needs a little rounding out to give the face a more youthful appearance.  I just think you might need some more, you have moderate volume loss in your picture.  This area is just great to use the blunt cannulas for less bruising, downtime, and swelling.  A great alternative to Radiesse would be Sculptra for volumizing the entire face, including temples, lower cheeks, marionette area, and pre-auricular (in front of ear) area.  Dr. Weiner, Destin, Florida.

Q: Radiesse Injection Technique-internal (Through Mouth) Vs External?

A: Radiesse should not be injected through the mouth

When injecting through the mouth, you risk dragging oral bacteria along the needle and infecting the area where the filler is placed.  There is no advantage to this technique.  The absolute safest way to inject Radiesse in my opinion is using the blunt cannula technique.  There risk of bruising, swelling, and vascular injury is minimized and results are optimized.  Cleansing the skin with Hibiclens and alcohol will help prevent infection.

Q: Radiesse Was Injected into my Trough/cheek Area About Six Weeks Ago.

A: 2 reasons why correction of Radiesse has gone

Radiesse has typically more swelling than all the other fillers.  So after about 3 days, the initial correction will look less corrected.  Also, Radiesse is a combination of Calcium spheres and a liquid medium.  The liquid will gradually absorb over a 3 week period.  Collagen will take some time (maybe 4-6 weeks) to form.  So there is typically a loss of correction which then comes back somewhat when collagen is formed.

Q: Percentage of Patients That Had No Radiesse Side Effects?

A: Very little side effects can be expected with Radiesse, especially with blunt cannulas

The stories on this site showing side effects from Radiesse are quite frankly not related to the product but to the person injecting.  If not properly placed in a deep plane or too much is placed in a single area, you can have some issues.  But, with an experienced injector, you will be able to resume normal activity the following day.  I tell my filler patients to avoid exercise for the first day to minimize bruising.  Using the blunt cannula technique, bruising is almost nil.  You can expect slight firmness in the area injected for about 3 days, but usually this is not noticeable.  Do not have Radiesse injected too close to the eye, and I wouldn’t do it in the nose.

Q: Is It Ok to Have Radiesse Nose Injection 5 Months After Restylane Nose Injection? Fly Immediately After Radiesse Nose Injection?

A: Injections of filler in the nose, not as safe as once thought

There are more and more reports of complications coming from nasal injections with fillers of vascular compromise.  Prior nasal surgery puts you at particular risk.  After knowing that, and you still want to get it done, I would only recommend using an HA filler (Restylane, Juvederm, Perlane) because there is a way to dissolve these products if a problem arises.  Radiesse can not be dissolved and posses a problem if an issue happens.  There is no problem with “mixing” fillers by injection the same area as a prior injection.

Q: Can Improved Radiesse (2010) Be Used Under the Eyes?

A: Radiesse good for upper cheek but not superficial

I have been using Radiesse for years in the upper cheek, particularly medially without issues.  When you get into issues I believe is when you try to inject superficial near the eye.  If you keep the volumes small, stay near the bone, and not too high, it works very well.  By the way, the formulation for Radiesse is unchanged since it’s inception.

Q: Is There a Way to Speed Up Radiesse Absorption?

A: Radiesse has more swelling than other fillers for about 4 days

I warn my cllents about the swelling you get with Radiesse.  It’s different than the other fillers.  I have warned my clients about the “Joker” look (from Batman) after getting it around the mouth which always settles down.  It really helps to turn up the corners of the mouth.  It should get better.  There is nothing to dissolve Radiesse however.

Q: Possible to Remove Radiesse Lumps in Lips?

A: Radiesse is not a lip filler

Radiesse should not be used to fill lips. It will clump most of the time.  Usually these can be removed with small incisions overlying the bumps.

Q: Getting Radiesse from a Plastic Surgeon or a Gynecologist?

A: Radiesse is an unforgiving filler

Having longevity in a dermal filler is good and bad. Good, if the results are what you want; bad, if you have an issue. I would say that my patients are most satisfied with Radiesse when compared to the other fillers (a study done by Radiesse came out with similar results).

Having said that, if you are considering Radiesse, you need to have a very experienced injector. Unfortunately, there is no remover for Radiesse as there is for the HA fillers. You need surgery to remove Radiesse.

In conclusion, read Dr. Persky’s notes, and make an educated decision.

Q: Radiesse for Lip Wrinkles?

A: Best treatment is to resurface upper lip for lip wrinkles

For the optimal results for upper lip lines with a prolonged results, CO2 laser is what I recommend. The Fraxel re:pair is excellent for this. You can see an example in my pictures.

Just doing this area is very easy. No pain med, no sedation, topical and blocks will make you extremely comfortable. About 5 days of healing time are needed. Sometimes a second treatment will be needed.

Another option is fillers and Botox. I do inject Radiesse horizontally very lightly along the area above the lip which helps somewhat, but not in the lip or directly into the lip lines. HA’s can be injected into these lines, but sometimes can be seen. In the future, Evolence Breeze will be great for this.

Q: Best Method of Injection for Radiesse?

A: Very comfortable injections with Radiesse is easy

The physician numbs the face with topical anesthetic for about 20 minutes. He/She mixes the Radiesse with lidocaine. Apply ice to the face for about 15 seconds. You should have minimal discomfort. If that’s not the case. Dental blocks are not needed. In my opinion, the blocks have more discomfort than the injection, and people usually don’t like the numb feeling they get from it.

Q: Radiesse After Success with Juvederm?

A: I would stick with HA fillers for the tear trough

I think that HA’s are best for the tear trough area. Their longevity there should be about a year. Although Radiesse is shunned by many in this area, it can be done by a skilled injector without issues. By the way, my favorite for this area is Restylane. The key to this area is to inject conservatively.

Q: Feeling the Radiesse in Nasolabial Folds Normal?

A: Not normal after Radiesse, but not necessarily a bad thing

Radiesse typically will swell and feel firm for the first few days, and should not be able to be felt after about a week or 2. If you still feel it, it could be that there was too much placed in that area. Usually massaging the area can break this up. I would recommend that. Ultimately, it should get better on its own in about 9 – 12 months.

Q: Tips for Avoiding Radiesse Pain

A: Radiesse is not painful for my patients

I routinely add lidocaine to all my Radiesse injections. This significantly decreases my patient’s pain. Also, by applying Pliaglis, a new topical anesthetic, there is virtually no pain. Applying ice before also helps. The lidocaine added will give short term pain relief as well, while the patient is driving home. After it wears off, the painful time period has usually lapsed.

Q: Radiesse for Nasolabial Folds

A: Radiesse is great for nasolabial folds

I think that Radiesse is great for the nasolabial folds. It will give a long term correction of about 12-18 months. A couple things that are particular to Radiesse is that it:

  • Swells more than the other fillers, but this goes away after a couple days
  • Causes slightly more bruising because you have to use a large needle to inject it

I do add lidocaine to the syringe, so it is a fairly comfortable injection. I love Radiesse for the marionette lines. It seems to have more structural support than any other filler and is great to turn a downward corner of the mouth, upward. One syringe of Radiesse is 1.3cc’s.

Also, Radiesse corrects about 30% better than Restylane. So, you get about 50-60% more correction per syringe of Radiesse over Restylane. You also get more longevity. So overall, it is the most economical filler.

Radiesse is made of microscopic calcium particles and a gel. The gel will dissolve and leave the particles which cause collagen stimulation. The new collagen is what leads to it’s longevity. I sometimes will layer a thinner filler like Juvederm or Restylane on top of the Radiesse. I think of Radiesse as a foundation, and the other 2 as finishers

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