How Effective is 1.5cc Radiesse for Deep Glabellar Lines?

Radiesse is an excellent filler.  However, for treating deep frown lines, a combination of Juvederm and Botox will likely produce the best and most natural looking, and feeling results.  The Juvederm will work to fill the existing furrows, and the Botox will work to relax the muscle to preclude the muscle from moving - which caused the wrinkles in the first place.  Adding Botox will also have the added benefit of possibly causing your filler to be longer-lasting, as the muscle will be relaxed.  

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).

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.