"We're finding that the Radiesse has been fairly predictable over the first 12 months as a soft-tissue filler. After that time period, we're starting to see a variety of time lengths that the implants seem to maintain their corrections. Some people experience 100 percent correction after 12 months to up to two years. And others have 30 percent correction in that same one- to two-year follow up. It can even vary within the patient in terms of comparing one nasolabial fold to the other. In fact, one patient looks like she has 100 percent correction on one side versus about a 50 percent remaining correction on the other," says Miles H. Graivier, M.D., F.A.C.S. He is a board-certified plastic surgeon, a private practitioner in North Atlanta Plastic Surgery, and a main clinical investigator for the product, along with David A. Jansen, M.D., Tulane University.
The product includes 70 percent sodium carboxymethylcellulose carrier gel (the rest is calcium hydroxyapatite microspheres). Over time, up to 70 percent of the product's volume is replaced by the patient's own connective tissue.
However, he says, "it's difficult to predict the exact volume replacement of the gel carrier that's going on. As with any other injectable, patients have different metabolisms and skin types."
Such factors affect a wide variety of fillers.
Dr. Graivier says, "We certainly know that with collagen, we have many patients who would come in after three weeks and say that all the product was gone. In others, it would last six months. So with almost all injectable products, there's some subjectivity.
"With Radiesse, now that we're getting out to the two-year period, we're finding that it's not lasting as long as we may hope. It's still an intermediate-range injectable filler because the microspheres that compose 30 percent of the product volume will eventually be degraded as well," he says.
At press time, researchers were still tabulating results. So far, they've established that about 38 percent of patients come back for touch up work between 1 and 3 months post-treatment. They do recommend that patients be seen during the first year after injection as most patients will request a small touch up. Average touch up volume totals 0.3 cc. On average, doctors use approximately 1 cc total for initial treatment of both nasolabial folds, although some patients require more, depending on the folds' depth.