My doctor advised me to try Radiesse after Voluma. Is this safe?
Doctor Answers 11
Radiesse versus Voluma
Using Radiesse on top of Voluma is safe, but you need to clarify with your doctor why different fillers were used
To give you a little about my background — I am a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. My experience with fillers extends all the way back to the introduction of the first filler, which were made up of collagen called Zyderm and Zyplast. Nowadays, there are so much more options for filling different areas of volume loss, and the key thing here is to understand the concept of fillers and their role in restoring structure in the mid-face region.
In the absence of any photos and a physical examination, it is of course more difficult for me to give a more concrete diagnosis or conclusion. I would suspect, however, that it is possible that you are losing volume as part of the normal facial aging process, and that you want to enhance volume in a particular area that you want to augment and accentuate. In terms of safety, I don’t think you need to second-guess your doctor’s judgment too much, as I don’t think your doctor will consider doing Radiesse on top of Voluma if they felt that it would not be safe. What is important is to avoid the risk of infection, inflammation, as well as issues with irregularities and unevenness.
Now, Voluma was a milestone in the development of fillers. Allergen obtained FDA approval for Voluma, which is important because this was highly viscous hyaluronic acid filler that was approved for use in the mid-face. However, over the years of doing mid-face lifting and soft tissue augmentation, I observed that the cheek pad or the malar fat pad where the material is placed possesses some anatomical limitations.
When you place a certain amount of volume in the soft tissue of the cheek, you are basically relying on the tone of the skin, as well as the ability of the underlying structure, to maintain the position of the volume that’s being placed. It is possible that what you may view as an under correction may be due to the material diffusing or the skin itself sagging. Often, doctors will try to overcompensate for the sagging by pumping the area with filler, which is why you’ll sometimes see people walking around with giant, pillowy-looking cheeks.
When a patient wants something more permanent than fillers, cheek implants can also be wonderful solutions for filling out this area. But in today’s fast-paced world, I find that using fillers is more beneficial because it allows me to sculpt the material much more accurately and in a way that I simply can’t do with cheek implants.
In terms of adding Radiesse, your doctor may possibly just want to add a little bit more material that is more viscous. Radiesse is a different type of filler that is certainly thicker and of a higher density, as it is a suspension of fine particles of calcium hydroxyapatite.
That said, what we do in our practice is a method called structural volumizing. With this method, rather than placing the material in the soft tissue of the cheeks, we place it much deeper — underneath the muscle and near the bone structure, so that we have a more solid foundation to build up the structure of the cheek. We’ll usually use several syringes of hyaluronic acid filler such as Voluma or Juvederm Ultra Plus and place it in the deeper structural levels of the cheek. The material does not slide out of position or dissipate, so we are able to achieve a nice accentuation of the cheek.
Structural volumizing is another strategy you can consider in the future, but at this point, I think it’s important that you meet with your doctor and discuss the type of strategy they are offering you. Ask for an explanation as to why they want to use Radiesse on top of Voluma, and not just more Voluma instead. Is it because you are metabolizing it? Or is it because it’s not reaching the level of correction needed? Clarity and communication is extremely important between patient and doctor.
I hope that was helpful and I wish you the best of luck!
Radiesse after Voluma
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I hope this helps. Best wishes.
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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.