How many syringes of Radiesse for my nasolabial folds would I need? (Photo)

The photo you have provided is very helpful.  I completely understand your desire for a facelift and you are absolutely correct in seeking out facial fillers in order to help with some of the issues you are concerned with about your face.  What you are seeing in your photo is that your face has lost volume.  Your once prominent cheeks have not only fallen to created the nasolabial folds, but they have lost some of their youthful volume.  If price is an issue, rather than putting all of the Radiesse into the nasolabial folds, ask your doctor what they might suggest in terms of filling the cheeks and perhaps addressing the loss of fat and hollowness under your eyes with Restylane or Boletero.  I don't think that putting Radiesse into the nasolabial folds without volumizing other areas of your face will leave you looking more youthful and refreshed. 

The pace at which you correct the nasobial folds is an important guide in choosing how many fillers to use. I would begin with either one or two syringes depending on your time frame and your desire for change. The stimulatory effects of Radiesse often take one to three months. Best, Dr. Karamanoukian Los Angeles

In my opinion, you should not focus only on the nasolabial Folds. You need revolumizing combined with skin tightening.I personally don't like Radiesse  as it does not last as long as some other materials. Furthermore, The new microneedle insulated radio-frequency produces excellent tightening without much downtime. If you don't need your neck  done, non invasive treatments may be excellent. If you need your neck muscles tightened, Surgery is the way to go.Even with surgery, a filter or fat transplant should be combined.Good luck!

First it should be pointed out that a facelift and fillers do not do exactly the same thing.  Your nasolabial folds should respond well to fillers including Radiesse.  It should take 1-2 syringes and cost will vary a great deal as to where you are located

Most patients require 1/2 of a 1.5-cc syringe per side to achieve adequate correction. Occasionally, more is needed.

By treating the NLF, you are treating the symptom and not the cause of the problem.  Volumizing the cheek would improve the NLF, eye area, and would be a better use of your dollars.  One further step would be to volumize the entire face with Sculptra.  If just doing NLF, one syringe of Radiesse on each side would work.  I hardly use that filler and prefer Perlane, Voluma, or Sculptra instead.

Fillers are great when used by themselves but are even more powerful when used with other modalities to treat facial aging.  One in particular (short of a facelift) is called ThermiLift.  It's a new micro-invasive procedure that is used to treat skin laxity.  It doesn't provide you with the same results as a facelift, but it yields far more impressive results than traditional non-invasive treatments such as Ultherapy and Thermage.  To answer your question, it all depends on your expectations and whether or not you employ another modality to treat the skin laxity.  I believe 1 syringe of Radiesse will look nice, but you will probable need more to achieve more of a significant change. 

Fillers are not a substitute for surgery for facial aging.Non-invasive treatments, like fraxel, ultherapy , thermage non-invasive laser facials do not work.Find a board certified plastic surgeon and have a consult for appropriate treatment

Thank you for your question and for posting pictures.You will need an integrated approach to achieve your goal of obliterating the nasolabial folds which will include Radiesse (as filler), skin tightening (Ultherapy or RF based) and fractional laser work. Find someon who can help you achieve your goals. I recommend at least one vial of Radiesse or 2 tretments with Sculptra for facial volumization.Read the Ultherapy book on the link below. Best,Dr. Karamanoukian

I’m a cosmetic oculofacial plastic surgeon and also a board certified
cosmetic surgeon. I do a lot of facial rejuvenation surgeries, and wrote a book
about this years ago. I have been in practice in Manhattan and Long Island for
over 20 years and I have certainly a wide range of experience for people like you
with the same concern.



One of the first things that came to my mind when
I read your question was how you came up with the conclusion that Radiesse was
the ideal treatment for you. In some situations, it may be because a doctor
recommended it to you or because you may have read that Radiesse lasts fairly
long. In our practice, when we determine the type of fillers that we use, we
also use a step back to help our patients understand what fillers can and
cannot do. Most people would focus on
the nasolabial folds and they missed looking at the area around the nasolabial
folds.



As we get older, we deal with two issues: one is volume loss and
another is descent. Volume loss is loss
of bone, muscle and fat. The nasolabial folds can become more prominent
relative to surrounding volume loss, which can be addressed with a facelift.



There are also other options to address the nasolabial folds. I always
educate my patients as we sit together in front of a mirror. I’ll also put
their pictures on the screen to give perspective on the improvement of the area
that bothers them versus a global improvement. We’ll also offer an option that
may be more practical with a more global improvement. These options include
volume in the cheeks with fillers, and combination of fillers like Restylane,
Juvederm, Voluma as well as the use of platelet-rich plasma (PRP). We also
perform a procedure called a Y Lift® which is a method developed by my friend
and colleague, Dr. Trokel, who came up with this method of applying an average
of 14-17 syringes of thick hyaluronic acid filler like Juvederm and Voluma in
various structures of the face to create a lifting effect that is comparable to
a facelift. It does have long-term benefit and we do offer that in our practice.
These are options that you can consider while you are getting the funds or the
time to have a surgical facelift.



I would suggest that when you think about volume like Radiesse, it’s
also important to know the volume a syringe has. Syringes typically contain 1cc
or 1 milliliter which is equivalent to a small teaspoon, so isn't much. We also
want to emphasize to our patients that syringes are expensive and you want to
use them intelligently to get the maximal impact. I may suggest that you place
this in the submalar area or the cheek area rather than the nasolabial folds to
get some balance. As we get older, the face comes down and the jowls occur so
there’s squaring off. When we’re younger, there’s a heart shape to the face, so
a Y Lift® is beneficial in cases like this.



Before considering Radiesse, you have to be very clear about the
outcome and what will actually happen. Patients come to us who had fillers done
elsewhere and they’ll say that they got a number of fillers in the nasolabial
folds and they still have them. I explain to them that we can’t erase these
lines, but we can soften them. You need an option that integrates everything
and come up with a plan that really provides you with the best value with the
amount of money and time you are investing. I hope that was helpful, I wish you
the best of luck, and thank you for your question.



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