I am scheduled for radiesse filler on glabellar lines, upper eyelid blepharoplasty and secondary full face CO2 laser. Is Radiesse best option for between brows? Would it be advised to be doing all three procedures together? Brow area was not affected with full face laser 10 months ago.
How Effective is 1.5cc Radiesse for Deep Glabellar Lines?
Doctor Answers (13)
Combine HA fillers and Botox / Dysport for glabella
Radiesse is an excellent filler. However, for treating deep frown lines, a combination of Juvederm and Botox will likely produce the best and most natural looking, and feeling results. The Juvederm will work to fill the existing furrows, and the Botox will work to relax the muscle to preclude the muscle from moving - which caused the wrinkles in the first place. Adding Botox will also have the added benefit of possibly causing your filler to be longer-lasting, as the muscle will be relaxed.
No Thick Fillers Should Be Placed in the Glabella
No, no thick fillers should be placed in the Glabella. Fillers can restrict flow of the thin walled vein traveling in the notch, by the head of the eyebrow, within each side of the Glabellar area. This complication has been reported and if vein constriction does occurs, a quarter sized area of skin, of the forehead turns black, dies and you're left with a hole that takes months to heal...leaving a nasty scar. Some MD's ignore this and place fillers here but you should not take that risk. Botox...fine.
Radiesse for glabella
It is always difficult to advise on the best course of treatment without seeing you and evaluating how deep your glabellar furrow is. Regardless of depth however, the first thing I would do is a neurotoxin like Botox or Dysport. If necessary, once the neurotoxin has taken effect to soften the lines and relax the muscles, a filler could be used to help smooth the crease further but I would suggest something like Restylane or Juvederm (softer and more pliable than Radiesse for this area and dissolvable in case anything happens and the product needs to be removed)
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Radiesse for Deep Glabellar Lines
Radiesse is a great filler for deep lines and to improve the volume of areas of the face such as the cheekbones. Botox and other neuromodulators are better for lines in the forehead region as they paralyze the muscles. Radiesse is better for nasolabial and deep lines.
Glabella area is best treated by botox and restylane or juvederm not radiesse
There have been rare cases reported of blood flow compromised by the injection of thick fillers in the glabella. Back int he days of collagen injections, Zyplast, the deeper product compared with Zyderm I or II, was not used because of this risk. Radiesse is a more viscous or thick product than Restylane or Juvederm so the Radiesse may increase the risk of ulceration of the skin of the forehead, not just the glabella. It is not known if this is because the filler gets in the vessel or if the filler constricts the vessel from the outside compression. If there is a sudden sign of such a complication, Resylane and Juvederm can be dissolved by adding hyaluronidase but one can't do this with Radiesse. Other products to avoid in this region are Perlane and Juvederm UltraPlus (Juvederm Ultra is fine).
Radiesse for Deep Glabellar Lines
I use a filler such as Radiesse combined with Botox to treat deep glabellar lines. It is safe to do this and the blepharoplasty and CO2 laser at the same time.
Radiesse is amazing, Botox or Dysport may be what you need
Radiesse is one of my favorite of all fillers because the results are amazing. It is one of my favorite procedures to do because I can be an artist with the face. It is a wonderful filler for many areas of the face, in particular, it is extremely effective for reestablishing the descent of the mid-cheek, nasolabial folds, downward angulation of the corners of the mouth, marionette lines and the jowls. The fill is done to the point of correction so you can see the end result immediately. This is unlike other fillers that take time to reveal the augmentation (ie. Sculptra) or those that require over correction at the time of treatment due to absorption over time (ie. Collagen).
Radiesse is NOT recommended between the eyebrows. Looking at your picture, your nasolabial folds would be addressed adequately with Radiesse and I am sure you will be happy. It does not appear as though you have aged much at this time. The wrinkle between the eyebrows is usually best treated with the paralytic agents- Botox or Dysport. Usually, if you do 2 injections, which will paralyze the muscles for 6-8 months, this wrinkle will go away on it's own. If you have the need for immediate correction, the paralytics can be combined with a filler. If you are having areas with persistent deep wrinkles, you could consider a dermabrasion to that area in particular. The advantage of this is that dermabrasion, unlike C02, does not cause heat injury or damage to the pigment cells, therefore it is possible to go deeper without causing a pigment change. The other advantage of a dermabrasion over the laser is that the deep wrinkles are worked individually to allow better correction of each deep wrinkle.
Hopefully this will help with your concerns regarding upcoming procedure.
Fillers for glabellar lines
Radiess is not for glabellar lines
Radiesse is an excellent volumizing filler, however, it should not be used in glabellar lines due to high risk of side effects.
The most worrisome side effect of injecting Radiesse in the glabella is the risk of compressing the blood vessels in that area, leading to necrosis and ulceration. The other, less likely possibility is that Radiesse may be injected into a blood vessel and block it.
Hyaluronic acid fillers are much better suited to the glabellar area. Although the same risks apply, hyaluronic acid fillers can be quickly dissolved with hyaluronidase, should compression of the blood vessels occur.
When used in the glabellar area, the combination of hyaluronic acid filler, like Juvederm or Restylane, with Botox works very well. The filler is used to elevate and smooth the static wrinkles and lines in the glabella (ones that don't disappear when the face is relaxed) while Botox relaxes the muscles that formed these wrinkles in the first place. This combination has excellent longevity in the glabellar area.
Please make sure your injecting physician has proper training and experience with filler injections in the glabellar area.
Radiesse should not be used for glabellar lines
Due to the depth of injection required for proper treatment with Radiesse, it should never be used in the glabellar area. For deep glabellar lines the combination of either Botox or Dysport with a hyaluronic acid filler such as Restylane or Juvederm is extremely effective and is the treatment of choice for this area.