Radiesse dilution question clarified. What is the benefit?

Question

I have been to many doctors and have also done research where doctors use more lidocaine beyond recommend dosage..My question is why do some use more than others.What is the benefit?

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Often times, a physician will dilute the syringe with more lidocaine to allow for a smoother dispersion of the product.  You are still getting the same syringe.  The more you dilute, however, the more you have to discount the evaluation during the procedure as some of the volume will go away.

Jeffrey S. Rosenthal, MD · Answer

The dilution of Radiesse depends upon what the surgeon is trying to achieve.  The placement of Radiesse is an Art and a science. To lift and contour a lower dilution is used; however, if more subtle sculpting is necessary then the Radiesse may be diluted a bit more.  Radiesse is placed in the deeper tissues of the face to lift, fill and contour the face; however, in certain areas the injector may place the Radiesse in a different level requiring a different consistency of the Radiesse. Either way you should be still receiving the amount that came in the syringe.  A good example of varying the dilution is when the backs of the hands are contoured.  The amount of liquid mixed with Radiesse is greater in these situations.

Jason Emer, MD · Answer

Mixing in more lidocaine can make the product more moveable and moldable which is good in certain instances like the hands, chest, or pan facial augmentation.  There is less risk of lumps and bumps this way.  Best, Dr. Emer.

J. Kevin Duplechain, MD, FACS · Answer

With the introduction of Radiesse plus, the need to add lidocaine as a comfort measure has been reduced.  However, in many instances, having a product that is a little less stiff or more malleable, particularly if being injected superficially as in hand rejuvenation, is more desirable, and can easily be accomplished by adding small additional volumes of lidocaine.  Other products like saline would work, but lidocaine is commonly used because of the additional anesthetic effect.  Diluting or customizing injectable products is not unique to radiesse.

Douglas Wu, MD · Answer

There is no "standard" way that every physician dilutes Radiesse.  However, the clinical trials that led to FDA approval for Radiesse to the hands utilized 1.2 cc of Radiesse mixed with 0.3 cc of 1% lidocaine for a total volume of 1.5 cc.  This is now how the product is packaged and so technically no further dilution is necessary.That being said, depending on the body site being treated and what the goal is, various dilutions of Radiesse can be beneficial in that the greater volume can be spread over a greater surface area and may distribute more evenly.  Not only lidocaine, but saline is also sometimes used in the dilution.  Next time you see your provider, it won't hurt to just ask him or her why they use the dilution that they do.  It may make for interesting conversation!

Heidi A. Waldorf, MD · Answer

Original radiesse does not contain  lidocaine - those of us who are experienced injectors have developed our own best practices for how much anesthetic we add.  More anesthetic makes the product less viscous or stiff. I prefer higher amounts of anesthetic for the lower face and higher still for the hands - it allows me to spread and mold the product in those areas. With the approval of radiesse plus which includes lidocaine in powder form, we have an off the shelf option for areas where we want to provide more lift with a stiffer product.Remember that the company is limited to recommending the exact dosing used in the study used for FDA approval. Physicians then determine best practices which often include 'off label' uses and indications.best of luck!

Kyle T. Yamamoto, MD · Answer

Adding lidocaine to Radiesse does two things.  1) It adds anesthetic properties to the injection to make the procedure more comfortable to the patient.  2) It changes the flow properties of the product during the injection.Depending on the individual doctor's injection technique or experience, the amount of lidocaine added is selected based mostly on preference.  In the end, the amount of lidocaine should not effect overall outcome.Also, Radiesse now comes in Radiesse + which has lidocaine premixed into the syringe.  No additional mixing necessary.

Melvin Elson, MD · Answer

Every doctor has his own recipe so to speak; however, it is really a moot point as Radiesse now comes with Lidocaine already in it and since it is a different form that the doctor would use it is much more effective and the product is very smooth

Radiesse dilution question clarified. What is the benefit?

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