Does mixing Radiesse with lidocaine alter the results?

I had Radiesse (1.5cc) injected once with lidocaine and once without it. With lidocaine my face deflated in 2 days and it looks as if I barely had any filler placed. Also, a deep injection method was used. The doctor used 1.5cc Radiesse with equal parts lidocaine. When I had Radiesse without mixing with lidocaine my results were very visible and lasted. Also, the doctor used a threading technique.

Doctor Answers 19

Radiesse and Lidocaine

Radiesse is a great filler for filling in deeper lines and for replacing lost volume in the mid face. Most practitioners routinely mix it with lidocaine to help with pain from the injections. Usually this is combined with topical numbing creams or nerve blocks (although nerve blocks can hurt quite a bit!). Radiesse is meant to be used below the dermis. Regarding your specific results, in my opinion, that's a lot of lidocaine to mix in. When you think about it, half of the volume that is injected is lidocaine, which dissipates, and another small percentage is a gel carrier, so LESS than half of the injected volume was the active ingredient. If you liked how you looked immediately following the injection, you probably just need another syringe.


College Station Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Radiesse with lidocaine

No, the lidocaine has nothing to do with your results. Lidocaine dissipates quickly from an injected area and is used to block the area from pain. Some fillers like Restylane and Juvederm have lidocaine pre-mixed into the syringes to help with pain. Radiesse doesn't have this so many injectors chose to do a lidocaine block before the procedure. Also, technically, Radiesse is supposed to be used at deeper depths; but the depth of the filler is what is impacting your results. Not the lidocaine.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Radiesse for Hand Rejuvenation

Radiesse for Hand  RejuvenationUsing a small amount of saline or lidocaine will allow the Radiesse to flow more evenly to the areas requiring filling.A small amount of epinephrine in the lidocaine may diminish bruising , but this is not much of a problemRADIESSE® can be combined with a numbing cream to minimize discomfort during the injection/s. A small needle is placed under the skin to administer the product. Typical treatment time is 15-20 minutes. What to expect after your RADIESSE® treatment? Results will be seen immediately following your treatment at our Newport Beach med-spa. You may experience temporary minor swelling, bruising, tenderness of the injected area/s, and lumps. Side effects should subside within a few days. After your visit you can resume daily activities, however you will be asked to avoid exercise for approximately 48 hours. You will be given specific instructions following treatment.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Radiesse and lidocaine

Merz, the makers of Radiesse, encourage the use of Radiesse mixed with lidocaine. Soon the lidocaine will come pre-mixed in the syringe. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Radiesse with Lidocaine

Mixing lidocaine with Radiesse should not have a negative effect or affect its longevity just as long as equal Radiesse volumes are placed .

Radiesse results may vary

Results can vary, especially when it comes to provider technique. Ideally Radiesse should be placed both deep and slightly superficially for the most benefit. Fillers are difficult to get just right so its important to choose a VERY experienced provider for your treatment.

Kimberly Butterwick, MD
San Diego Dermatologic Surgeon
5.0 out of 5 stars 15 reviews

Altering the results of Radiesse

Regarding placement with Radiesse, it depends on the location as to what type of injection can be used. I would use a combination of both deep and threading technique. It is fairly standard to mixing Radiesse with Lidocaine. I will use 0.2 Lidocaine with 1.5 cc Radiesse.

Jeffrey W. Hall, MD
Austin Plastic Surgeon
4.4 out of 5 stars 16 reviews

No issue mixing Lidocaine into Radiesse

One can mix Radiesse with lidocaine, however the amount of lidocaine necessary is very small. As a result you do not see the deflation issues you experienced.

Stephen M.Davis, MD, FACS
Green Hills Plastic Surgery

Using lidocaine with fillers

MOST FILLERS DO HAVE LIDOCAINE BECAUSE IT COULD BE SLIGHTY PAINFUL BUT THE MORE LIDOCAINE IS USED THE MORE THE PRODUCT BECOMES MORE LIQUIFIED. SPEAK TO YOUR DOCTOR WITH YOUR CONCERNS

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.6 out of 5 stars 87 reviews

#Radiesse - Does mixing Radiesse with lidocaine alter the results?

Generally - no.

Most plastic surgeons mix lidocaine with Radiesse prior to injections - it is otherwise too painful.  While the addition of lidocaine does make the injected material somewhat more liquid, and therefore a little easier to spread evenly (than for a thicker material), I am not aware of any studies, and it is not my experience, that show that the addition of lidocaine changes the final result.

And it's a difficult study to do, and difficult to draw conclusions based on a small number of injectable experiences.  There are too many variables:  depth of injection, precise amount of material injected in any one spot, swelling from the injection, any bleeding at the time of the injections, etc.

But with respect only to the addition of lidocaine I would not say that the final result should be, or is, different.

I hope that this helps and good luck,

Dr. Alan Engler
Member of RealSelf100

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.