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. 

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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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