Does threading Radiesse work better than deep injections?

Question

I like Radiesse for my cheeks. One doctor used a threading technique on me 3 months ago and I saw dramatic results with just one 1.5 cc syringe. Recently I had another 1.5cc syringe put in my cheeks using a deep injection method and the results are minimal. What is the better of the two techniques? Which will give me better results without having to use a ton of filler? I feel like I'd have to use at least twice as much with the deep injections?

Parker A. Velargo, MD, FACS · Answer

In my hands, the technique of injection varies depending on the location of the injection.  For midface injections in the cheek, I get the best results with deep depot injections followed by manual molding.  For injections into the temple, I get the best results by bolusing the product as well.  Since Radiesse is a firm product, it is designed to be placed deeply.  I will use a linear threading technique for the injection of Radiesse into the nasolabial folds (line from nose to corner of mouth), marionnete folds (line from corner of mouth to jaw), or to support the oral commisure (corners of the mouth).  The longevity of the product depends on where it is placed (more movement = shorter duration) and the dilution with lidocaine (more lidocaine mixed in may mean more "stuff" to inject, but not more product per se).  I feel only "core" injectors should perform cosmetic injectables (facial 
plastic surgeons, plastic surgeons, dermatologists, or occuloplastic 
surgeons).  This is because we all have a keen understanding of facial 
anatomy and the effects of injecting Radiesse in different
 regions of the face.

Raffy Karamanoukian, MD, FACS · Answer

There are many different injection methods for Radiesse. All different types have a purpose and may improve results if performed together. Best, Dr. Karamanoukian Los Angeles

Larry S. Nichter, MD, MS, FACS · Answer

Both are acceptible techniques in the right hands. The key is finding the best injector rather than selecting the technique. See link for helpful hints.

Kimberly Butterwick, MD · Answer

Most patients need a full syringe on each side of the face for a noticible improvement.  Placing Radiesse deeper is usually recommended, although placement will depend on a number of factors that your provider will discuss with you.

Harold J. Kaplan, MD · Answer

Hi JB.  There is no single answer to this question other than to say that we believe you should visit the practitioner that was able to achieve your goals.  We use both threading and bolusing (deeper targeted injections) to accomplish patient goals in different situations.  Ultimately, the technique chosen is matched to the particular goals of the patient on that day and visit.  Radiesse is a great product for the cheeks, but the person using it is more important that the product itself.  To see examples of Orange County, CA patients that have had Radiesse injections, click the link below.

Jason Emer, MD · Answer

Radiesse can work well with any technique.  It is not the "filler" per say it is the "filler" who is doing the injection that gives the best results.  I use Radiesse deep for lifting and contouring and more superficial for volume and shaping.

Jeffrey W. Hall, MD · Answer

Radiesse is a great choice for the cheek area. The Technique is injector/client dependent. I personally will use deep in the "apple" or midcheek, and thread more toward the outside. No two people, nor two cheeks are exactly the same.

Michael H. Gold, MD · Answer

Thanks for the
question – both techniques work well in most when injecting the cheeks – with
most now favoring the deep depot technique and massage of the area over the
threading technique.

I would recommend
that you find a board-certified dermatologist or plastic surgeon that injects a
lot of Radiesse and then find which they recommend and have appropriate follow
up to make sure that you get the results you want from your volumizing
injections.

Kris M. Reddy, MD, FACS · Answer

The technique to be used is based on the goals/objectives of the patient and the location of the injection. Radiesse should be injected by an experienced and expert physician injector to avoid complications.

David A. Bray, Sr., MD · Answer

The technique of injection for any filler depends on what is to be achieved. Always use a skilled experienced physician.

Does threading Radiesse work better than deep injections?

Answers (11)

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