| Category Name | Content |
| Name | Radiesse (Calcium Hydroxylapatite Dermal Filler) |
| Uses | FDA-approved for moderate to severe facial wrinkles and folds (e.g., nasolabial folds), and for hand augmentation to restore volume loss. Off-label uses include jawline contouring and non-surgical rhinoplasty. |
| Route of Administration | Subdermal or supraperiosteal injection. |
| Frequency of Use | Maximum every 12 months for elective patients. Effects last 12–18 months. |
| Concentration(s) | Calcium hydroxylapatite (CaHA) microspheres in a gel carrier: 30% CaHA, 70% gel. |
| Maximum Dosage | Max 3.0 mL per session. Max 6.0 mL per 12-month period. |
| Contraindications | • Pregnancy, breastfeeding, or planning pregnancy. • Allergy to calcium hydroxylapatite or lidocaine. • History of severe allergies, anaphylaxis, or autoimmune conditions. • Active skin infections, acne, or inflammation in the treatment area. • History of vascular occlusion, necrosis, or embolism from previous procedures. • Use of blood thinners or immunosuppressive medications. • Patients under 22 years old (per FDA approval). |
| Possible Side Effects | • Common: Swelling, bruising, tenderness, redness at injection sites. • Rare: Nodules, granulomas, vascular occlusion, hypersensitivity reactions. • Severe: Anaphylaxis, arterial embolization, tissue necrosis requiring surgical intervention. |
| Compatibility With Other Treatments/Drugs | • Safe with: Neuromodulators (Botox, Dysport), most dermal fillers. • Avoid with: Recent laser treatments, chemical peels, or hyaluronic acid fillers in the same treatment area. |
| Allergies | Patients allergic to calcium hydroxylapatite or lidocaine should not receive treatment. |
| Administration Time | Injection procedure takes approximately 30–45 minutes, including preparation and aftercare. |
| Dosing/Settings | • Recommended starting dose: 0.5–1.5 mL per area, depending on treatment zone. • Maximum 1.5 mL per cheek or jawline in a single session. • Avoid injecting too superficially to prevent nodule formation. |
| What To Do If Adverse Reaction Occurs | • Vascular occlusion: Stop injection immediately, apply warm compress, massage area, refer to vascular specialist if needed. • Anaphylaxis: Administer epinephrine (0.3 mg IM), call 911, provide airway support. • Granulomas: Refer to dermatology for corticosteroid or 5-FU treatment. • Necrosis: Immediate referral to a specialist for wound care and potential debridement. |
| Additional Documentation Requirements | • Signed informed consent form. • Pre-treatment photos (frontal and side views). • Medical clearance if history of vascular complications, autoimmune disease, or recent oncology treatment. • Documentation of past filler treatments and allergy history. |
| Post-Treatment Care Instructions | • Avoid strenuous exercise, alcohol, and excessive sun exposure for 24 hours. • Apply cold compress if swelling or bruising occurs. • Do not manipulate or massage the treated area unless instructed by the provider. • Follow up in 2–4 weeks for reassessment and potential touch-up treatment if needed. |