The Hyaluronic acid (HA) fillers-- Restylane, Perlane , Juvederm Ultra and Juvederm Ultra Plus were my my workhorse fillers until I discovered Radiesse.
Radiesse provides excellent cosmetic improvement to the smile lines, the marionette lines at the corner of the mouth, to the hollows around the eye (the "tear trough " deformity) and to improve the volume in the cheeks, the pre jowl areas of the jawline as well as filling traumatic and congentital facial deformities. It can also improve depressions and irregularities that can occur after rhinoplasty.
The treatment definitely hurts less than using the hyaluronic acid fillers, especially when it is mixed with local anesthetic. Is also lasts longer (8-10 months and in some areas greater than 1 year). Radiesse is entirely different than the hyaluronic acid fillers being made up of hydroxyapatite microspheres suspended in a gel matrix. It is very safe to use except for lip enhancement, where it can cause irregularites.
Restylane and Juvederm are still my top choices for lip enhancement and both of these products can be layered on top of Radiesse to provide the closest thing to an ideal cosmetic result using off the shelf products....Samuel N. Pearl MD