Radiesse in conjunction with Ultherapy. Any suggestions?

There are actually some good studies that address this question specifically.  The studies suggest that if you are going to have Ultherapy and dermal fillers performed concurrently that it is best to have the Ultherapy treatment performed first. The deep heat from the Ultherapy can adversely affect the dermal fillers if you have your injections performed first.

Thank you for your question. You are asking a fairly common question related to non-invasive skin tightening technologies - Radiesse currently in your nasolabial fold and if it’s safe to have Ultherapy at the same time, and if it will potentially melt the Radiesse.

I can certainly give you some information based on how we discuss non-surgical therapies like Ultherapy in our practice. Although we don’t offer Ultherapy specifically, we have comparable technology. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years and I’ve been using various thermal devices including lasers since the mid-90s with the original CO2 laser to help people tighten their skin. We now have a variety of technology that offer dermal tightening as well as non-surgical fat reduction using various methods of heat induction, whether it’s radiofrequency, ultrasound, or laser technology.



The principle of these technologies is to induce a certain level of heat for a specific amount of time  to tighten the skin. By tightening the dermis, you can tighten areas such as the jawline, jowls, etc. We use a technology called the Nd:YAG laser which has this unique method of inducing temperature elevations in the skin that is slow and progressive so we avoid some of the pain issues people have with more common and popular technologies.



For the effect on the Radiesse, this depends on where the thermal energy device is being applied. Generally, we don’t treat the nasolabial fold directly. The temperature change in the skin can be avoided so there’s no effect on the Radiesse material. Radiesse is a material called calcium hydroxyapatite in a gel suspension. Theoretically, you could accelerate the gel breakdown, but the hydroxyapatite itself will not breakdown in that kind of heat because this is a material that’s like bone, so it’s very resistant to the temperature increase.



I think you really have to discuss with your doctor what the desired outcome would be with this or any other thermal energy device. When help our patients, whether it’s dermal tightening or spot fat reduction, we have different protocols and ways to apply the laser device without doing anything to the skin superficially, but inducing the heat to the deeper layers of the skin as well as the tissue underneath the skin to tighten it. We are really able to customize, so if we put fillers in the lip area, the nasolabial fold, or the chin, it’s not a problem because a laser device is very precise with control of heat and area it’s being applied. You can strategically limit where the heat is being placed ,and preserve the integrity where the fillers are placed, which is the ultimate goal.



Talk to your doctor about this and learn what the impact will be. Learn what the success of the treatment can be because I a lot of people are learning about thermal energy devices, but very often they expect more than what can be delivered, so a consultation is critical to get a realistic opinion of the outcome. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Ultherapy in conjunction with fillers is a great combination treatment approach.  I always recommend that patients have their Ultherapy treatments prior to filler injections.  Ultherapy uses micro-focused frequency ultrasound energy which precisely and consistently heats the targeted tissue to 60-70 degrees centigrade, which is the optimal temperature for contraction and denaturation of collagen.  However, it may be possible that this could heat up the filler and affect the filler duration.  In future treatments, you ultherapist will be able to see the filler on the ultrasound and avoid treating it.  Good Luck!