Storing Radiesse Mixed With Lidocaine OK?

Hello, Can any of you fine doctors tell me why once calcium hydroxylapateite (Radiesse) filler is mixed with lidocaine, ALL of it must be used up? I know that some of the hyaluronic fillers come premixed with lido (powder form) and are fine to store but I've heard this is not the case with Radiesse. Is there some chemical change that occurs if the two are stored together in a syringe for a period of time? Or is it just the added contamination concern with in-office mixing?

Doctor Answers 9

Storing Radiesse mixed with lidocaine

It is probably safe to store Radiesse with Lidocaine for a short amount of time but the problem is that no one knows how long this is because it is not an approved way to use Radiesse so there is no data. There are publications about other products and they show that the others were safe to store but there is nothing about safety or stability for Radiesse.
While the practice is probably fine, there is just no way to know and I typically inject full syringes and do not store anything.

Palm Beach Dermatologic Surgeon
5.0 out of 5 stars 8 reviews

Storing Radiesse Mixed With Lidocaine OK?

In general, once a sterile package is opened, the material contained within it should be used expeditiously, and not stored for a prolonged period.  The HA fillers now come with lidocaine already mixed in but, once opened, it's probably not advisable to leave them unused.  This has to do with at least the theoretical risk of contamination and subsequent injection of a product that is no longer sterile.  That being said, I don't know of clear data showing such a risk, but it seems to make sense.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Contamination with Storing Radiesse and Lidocaine

    In general, radiesse should be injected once opened and not stored due to risk of contamination or infection.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Storing Radiesse

In addition to the potential issue already mentioned with sterility, the other practical reason that Radiesse cannot be stored is that after a few days, the product becomes hard and is then impossible to inject.  This is true whether it is mixed with lidocaine or not.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Storing Radiesse Mixed With Lidocaine Ok?

Once you open up a filler syringe it is no longer sterile, so I wouldn't keep it to store if product is remaining per standard protocol fo the company (Merz).

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Once Radiesse is mixed with lidocaine...

It's better to use the full syringe of Radiesse and not store any unused portion.  Infection and contamination are theoretical risks with mixed stored products.  Radiesse comes in teo sizes: 0.8 mL and 1.5 mL, so if a lesser amount is needed, the smaller size can be used.

Donna Bilu Martin, MD
Aventura Dermatologist
5.0 out of 5 stars 1 review

Radiesse with lidocaine

The fillers you mention that come premixed with lidocaine have been approved by the FDA this way. Radiesse isn't approved with a combination of lidocaine mixed in, nor does it come this way from the manufacturer - that's why there is no definitive answer for you. All fillers are single-use syringes so technically none of them should ever be stored, plus once you open a syringe and expose it to air, changes in the potency of the filler can occur if not used within 1-2 weeks maximum. This is an additional reason that it's not recommended to partially use syringes. Smaller size syringes of every filler are available so rather than storing syringes, it's best to find the right size needed and use the entire syringe at once, regardless of whether or not it has lidocaine in it.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Storing Radiesse mixed with lidocaine

Radiesse is commonly mixed with lidocaine in the office just prior to injection (I do this myself for all of my injections). I am not aware of any studies showing how long Radiesse is still safe to use after it is mixed but this would depend on each physician and how sterile their technique was as well as whether or not lidocaine with preservative was used. Since I only mix in the lidocaine just prior to Radiesse injection and since partially used syringes should not be stored, it should not matter how long it can be stored after it is mixed.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Storing fillers

The syringe of fillers is one time use, can not be stored for future use because of possibility of contamination and infection. That is how you can mistakingly use one patients syringe on another and possible spread of hepatitis.

Once the syringe os opened it has to be used or discarded. The portion remaining not used has to be discarded. These are principles of preventing infections.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

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.