Can Radiesse work if Sculptra has failed? I have very severe facial lipoatrophy.

There would be no issue using Radiesse in an area previously treated with Sculptra, but I find it surprising that Sculptra did not help your facial lipoatrophy.  Sculptra is a stimulating agent that normally requires several treatment sessions to gradually produce volume replacement.  Depending on the severity of the facial lipoatrophy, it is possible that 6 or more treatment sessions would be needed.  The amount used with each treatment session would also make a difference in the results.  It is possible that you just were treated completely with Sculptra.  Radiesse is more of an immediate filler, so you would see more improvement right away but the result generally would not last as long as Sculptra.  

Sculptra  produces a subclinical inflammatory response which induces the fibroblasts to produce collagen. Radiesse is a filler and does not require the body to create volume. The two can be used separately or together and in any order. In my experience, Sculptra lasts longer than Radiesse. Find a cosmetic specialist. Ask to see photos.

Both Sculptra  and Radiesse stimulate the production of collagen by your body.  Radiesse is more of a voluminizing agent . It takes time for the collagen effect to work in both cases. 

Yes, you can have Sculptra after Radiesse. Keep in mind, it can take several weeks for final results with Radiesse. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Radiesse or other fillers can help create volume. Sculptra takes up to 6 months to see result so if you do not see result you made need another session. Some fillers work differently for everyone. Please consult with a board certified provider for any additional questions. 

Yes, you should be able to try radiesse as an alternative if sculptra was not effective.  Due to variability in biology, one filler may work better for you than others.  Consult with an experienced cosmetic dermatologist.

It is very reasonable to use Radiesse even if other fillers did not provide the expected volume. There is a special pricing program for Radiesse used in certain cases of facial lipoatrophy. Contact the manufacturer of Radiesse for details. Good luck!