What is better for flat cheekbones: Radiesse or Sculptra? Can they be combined?

Question

I am considering cheek filler. I have very flat cheekbones. I was wondering if radiesse or sculptra would be better to create a more 3-D shape. Can both treatments be combined? In the same area? Different area? Different sessions? Not combined at all? Thank you.

Harold J. Kaplan, MD · Answer

Hello TW.  There are numerous dermal fillers (Radiesse is one) or biostimulators (Sculptra) that can be used for cheek hollows.  We love both of these products for cheek volume.  Radiesse has the benefit of immediate results and is a great "foundation" where other fillers can be used on top.  Sculptra is a very natural looking product that also improves the texture of the skin.  The drawback is that you don't see full results with Sculptra for 6-9 months.  You are on the right track with your filler options.  Now to find a great injector to provide the service!  Best of luck.

Monica Boen, MD · Answer

Thank you for your question. Sculptra is a biostimulator that works deep in the dermal structure to trigger the body to produce more collagen. The process takes time, so you may not see positive improvement for many months. Once the volume develops, it can last for up to two years. The advantage of Sculptra is that the results are very natural, since they form at a cellular level. 
Radiesse is a filler that contains calcium. The filler forms a scaffolding in the dermal layers to produce quick results. At the same time, the formula stimulates the body to produce more collagen, for long-lasting improvement. Hyaluronic acid fillers are another option for adding volume to the face. These work by providing support in the underlying dermal structure to produce immediate results. One advantage to HA fillers is that they can be reversed if you don’t like your result. That option is not available with Radiesse. I recommend scheduling a consultation with an experienced, board-certified dermatologist for a full assessment and treatment recommendations.

Nelson Lee Novick, MD · Answer

With the introduction of robust, hyaluronic acid-based volumizing fillers a few years ago, I curtailed my usage of Radiesse significantly and completely stopped injecting Sculptra. Radiesse, which is a calcium-based filler back then offered the advantage of benefits lasting about two years in the cheeks. Sculptra, a relatively expensive injectable treatment that did not give rise to immediate benefits, offered the advantage of even longer-lasting results, by virtue of stimulating new, native collagen and elastic fiber synthesis, following a series of several treatment sessions spaced at 4-6 week intervals.  Neither was reversible, however, in the event that this was required or desired. Happily, in the past few years, a number of hyaluronic acid volumizing fillers, such as Voluma XC, Stylage XXL, Restylane Lyft and Neauvia Intense Flux, to name just a few, have been introduced that yield immediate, typically "Wow!" results following just one treatment, may last up to two years in some locations, such as the cheeks, and, if necessary can be dissolved with the use of an enzyme hyaluronidase. What's more, it seems that hyaluronic acid fillers also possess the ability to stimulate new, native collagen and elastic fiber synthesis.  For these reasons, I would suggest that you discuss these issues in consultation with a board certified aesthetic physician (and make certain to ask to see his/her personal before and after photos before agreeing to proceed). Best of luck.

Jacob Sedgh, MD · Answer

Sculptra and Radiesse are both considered two of the popular augmentation products for the cheek area. Sculpture is more of a collagen stimulating product and it will take a couple of months for augmentation to develop but Radiesse is a filler with immediate results. The downside of the latter is that it’s not fully reversible. They can be combined in the same region .

Daniel Barrett, MD · Answer

Dear Trustworthy7460,
Both fillers are good and can be used in your desired area. If you are considering injections, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Paul E. Goco, MD · Answer

Thanks for your question.  Both are fillers, but very different.  They can be combined.  Radiesse is an actuall filler material that will immediately lift tissues and give a 3D effect.  Sculptra is an injectable "biomodulator" meaning it does not fill immediately but stimulates your skin and soft tissues collagen to increase and then lift the tissues, it can take weeks to see an improvement.  Your provider should be able to instruct and give recommentations. Hopefully, this information helps!

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there,
     If you are looking for a more sculpted/sharp/chiseled look in this area, then Radiesse is the best option. Sculptra is a collagen stimulator, that does restore some natural fullness to the face, but does not allow for tiny changes and tweaks to be done. It is more general, less specific. Think of Sculptra as the cake, and Radiesse as the icing. Sculptra is a liquid suspension that is injected in the deep tissue. Radiesse is a calcium-based filler that has a significant amount of substance and firmness to it. Sculptra can be done to restore general volume to the cheek area, with Radiesse to follow, giving you that cheekbone look. If you decide to do both, I would complete a series of Sculptra, followed by several months of healing time. I would then inject the Radiesse. 
Hope this helps. 
Sarah RN BSN

Louis W. Apostolakis, MD · Answer

When it comes to facial volume injections, it is my opinion that the best option is a hyaluronic acid product.  These include many brands and "thicknesses", I use Voluma and Lyft for cheeks.  I am not in favor of using Sculptra.  Serious complications are vastly more common and very difficult to treat.  A well known complication is granuloma formation which may need to be surgically removed and can last decades.  Scultpra relies on your body reacting to the product to produce any result.  This reaction often simply doesn't happen, at least from an aesthetic perspective and if it does takes many months to appreciate.  Sculptra itself is not a filler, only your body's reaction to it causes filling.  Radiesse is a reasonable product.  However, it can not be dissolved on demand like a hyaluronic acid.  Radiesse produces an immediate filling affect and dissolves over time.  Hyaluoronic acid products also produce an immediate result that slowly diminishes over 1 to 2 years.  It is dissolvable on-demand and its chemistry (hyaluronic acid) is a material already in your body.

Camille Cash, MD · Answer

There are many products on the market to add volume and sculpt the cheek area.  Both products you mentioned are appropriate as are other HA fillers.  HA fillers may be recommended over Sculptra if you are wanting more immediate results.  Visit with an experienced injector near you for a consultation.  Together you can select the right product based on your treatment goals.

What is better for flat cheekbones: Radiesse or Sculptra? Can they be combined?

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