Swelling and bruising and improper placement.

Skimomma,

This is a good question. Many patient have products injected into them, but have no idea what they are getting into. There are many great products, including Radiesse. However, it is great that you are seeking out this information so that you will be an informed patient.

All fillers are injected through the skin with hypodermic needles. So, there is risk of bruising from puncturing microscopic capillary arteries in the dermis. Some products are anticoagulant in nature (such as the protein in Evolence) and other are pro-coagulant. Radiesse seems to have more bruising than some other products. It can, however, be mixed with other solutions which help reduce the bruising.

All fillers also induce swelling. This is a factor of the hydrophilicity of the product (attraction to water) and the trauma caused by the injection. All products have these properties to some extent. Radiesse seems to have a bit more swelling than other products.

All fillers are not made to be injected in the same place. Different fillers are ideal for different parts of the face. For instance, Radiesse is excellent for the cheeks and the nasolabial crease. Juvederm, Restylane, Prevelle and Evolence are great for the nasolabial crease, lips and perioral areas.

However, all fillers are technique-dependent and it is important that your injector have the skill and experience to inject the products properly and into the correct skin level.

I hope this is helpful.

David Shafer, MD
Shafer Plastic Surgery - New York City

Radiesse is a synthetic calcium hydroxyapatite filler. Calcium hydroxyapatite is the stuff that makes up your bone. The Radiesse people have made a synthetic version of this compound that is injected as a gel. The gel is great as a filler for deeper folds and wrinkles. It is great for the nasolabial folds, grooves under your eyes and any larger volume loss on your face. It lasts for about one year, although Bioform would like you to believe it lasts longer than that. One of the wonderful things about Radiesse is that it expends when injected and takes up more space than the other fillers. For example, to fill in a single area, studies have shown that 1.2cc of Radiesse will fill the same amount as 2.4 cc of collagen.
As for the adverse effects;
It is more painful than other fillers, so you need to have nerve blocks to alleviate the pain. It also may have more swelling and bruising than other fillers.
Most importantly, if it is injected into the lips, you can experience nodule or cyst formation in the lips. This adverse effect is not found when it is injected into other areas of the face.

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Radiesse should be avoided in the lips. They can form lumps and are difficult to treat. Most complications of Radiesse are due to lumps or irregularities from over injection. Some people can get granulomas or even infections. But this can happen with other fillers. Local bruising and swelling can occur too.

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