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Radiesse effective intermediate filler

Article-Radiesse effective intermediate filler

Colorado Springs, Colo. — Based on preliminary results of a two-year follow-up study, corrections made with injectable Radiesse (formerly Radiance, calcium hydroxyapatite; BioForm Medical, Franksville, Wis.) appear to last somewhere between 12 and 24 months. Investigators had hoped for longer duration, but the good news is the filler provides safe, effective intermediate corrections for a variety of cosmetic problems

"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.

Patient before (left), 22 months after (center) 1.4 cc in nasolabial folds (1cc + 0.4 cc 4 weeks later) and 24 months after (right) an additional 0.6 cc placed. Total = 2 cc/24 months. Results after 22 months show 95 percent correction on the right and 50 percent on the left. Photos courtesy of Miles H. Graivier, M.D., F.A.C.S.
Drs. Graivier and Jansen have been following up nearly 500 patients they have treated since the study began in an effort to determine the filler's longevity. "As with any injectable," Dr. Graivier states, "the predictability is varied. What we're finding is that when you inject Radiesse, sometimes the patient can still feel it a little bit, if they push on it, for the first four to six months. But then the tissue matures and softens."

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.

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