How Effective is 1.5cc Radiesse for Deep Glabellar Lines?

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.

Doctor Answers 13

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)



Los Angeles Plastic Surgeon
4.7 out of 5 stars 145 reviews

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.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon
5.0 out of 5 stars 1 review

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).

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

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.

Kimberley Lloyd O'Sullivan, MD
Providence Plastic Surgeon
4.9 out of 5 stars 18 reviews

Fillers for glabellar lines

Filler injection can be performed in glabellar areas with or without botulinum toxin such as Botox or Dysport but this is considered an off-labelled indication. Ideally hyaluronic acid filler such as Juvederm or Restylane should be done before Radiesse in case reversal is necessary as hyaluronidase is available to completely to dissolve hyaluronic acid filler. The key is to have procedure be done by an experienced board certified aesthetic physician who knows what to do to avoid and/or treat complications such as bumps or pending skin necrosis due to compromise in circulation.

William Ting, MD
Bay Area Dermatologic Surgeon
4.8 out of 5 stars 12 reviews

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.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

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.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Best treatment for deep glabellar lines.

Unless the lines are very deep, I prefer Juviderm (lasts a shorter time but is more forgiving than Radiesse) in combination with Botox.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Radiesse and Botox for deep glabellar lines

Radiesse may be used for deep glabellar line, and would be most effective in combination with Botox. The wrinkle in the glabellar area is mostly cause by dynamic movement of the glabellar muscles.  The potential risk of retinal artery embolism has kept some practitioners from injecting a filler to this area. Chemodenervation of these muscles with the use of Botox will prevent the muscles from moving and allow the wrinkle to be filled nicely with any filler such as Radiesse or Juvederm.

Kambiz Jacob Cohen-Kashi, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.