Radiesse for chin/jaw correction placement (into deep dermis or onto the bone)?

Radiesse is an excellent product for injection in the lower face to produce a more elegant jawline and to correct a recessed chin.  The placement of the product depends upon the location being injected, the result you wish to achieve, the preparation of the radiesse and the tool being used.  As a patient, you shouldn't have to worry about these factors -- that's one of the benefits of going to a physician board certified in a core cosmetic specialty like dermatology.  For example, to provide firm lift in the cheeks (an off label but common use of Radiesse), Radiesse (+)  generally injected on bone which adds to longevity and appearance. Injection on the  chin is often done similarly.   The supraperiosteum (cover of bone) and surrounding fibrous tissue has fibroblasts which can be stimulated as they can in the skin.  The jawline can be injected in the same way - with a series of bolus injections on bone using a needle -- or it can be approached with lengthwise injections using a cannula in the subdermis (it is hard to get a cannula all the way to bone).  Radiesse can also be used as a biostimulator without the heavy lifting similar to sculptra.  For that use, the radiesse is prepared (usually using the original Radiesse rather than Radiesse +) with lidocaine and saline to double or triple the volume.  This spreadable Radiesse is injected in thin streams in the dermis to act as both a structural and biostimulatory 'mesh',So rather than trying to figure out where your injections were placed, it sounds like your next step is to deal with the unevenness you see when you smile.   In that case, I recommend you return to your physician for re-evaluation to determine if it is just swelling that will resolve on its own, product placement which you can't adjust but can perhaps shift by putting filler in elsewhere, or a lump or bump of filler which can often be reduced with an injection of flourouracil and dilute steroid or saline.I hope that answer was helpful.  Best wishes.

For the prejowl sulcus, the skin is often attached to the bone, so injecting in dermis has limited effect, and can be augmented by injection in the preperiosteal plane as well. Using both planes gives a better result in my experience. 

Dear metrak,That is a very interesting question.  Radiesse can be injected in several different planes.  The more superficial you place it, the more visible its volume and irregularities will be.  Yes, "uneveness" would be less likely if placed on bone due to the greater thickness of overlying soft tissues.  Part of the volumizing effect of Radiesse has recently been attributed to the collagen production that it insights, mostly  for marketing purposes in response to the competition that it has with Sculptra.  However, the majority of the filling effect of Radiesse remains the volume of the material itself, not its collagen production.  Also, there is some collagen production in deeper tissue layers, it is just not as great as in the subdermal plane where the majority of the fibroblasts that produce collagen reside.  Good luck!

 Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.   Conversely, women look feminine and attractive with heart-shaped faces.  Heart shaped faces have cheeks that are full and round "in the front" which can be created with precise placement of a dermal filler or silastic cheek implants.   The back portion of the jaw line can be augmented, in women, without masculinizing the jaw line and face.  I prefer using Restylane Lyft in women but will also use Radiesse (injected into the fatty layer under the skin) to augment the mandibular angles in men. Hope this helps.