What should first be done before considering injectable calcium hydroxylapatite?

First, an ASDS dermatologist will review the patient’s medical history and examine the condition to be treated. Areas to be treated should be kept clean. If there is a skin infection, then treatment needs to be postponed until it resolves. Patients who take blood thinners (such as aspirin, ibuprofen, and certain herbal medications) should stop them two weeks prior to injection with the approval of their prescribing doctor.

Injectable Calcium Hydroxylapatite

What is injectable calcium hydroxylapatite?

As part of the aging process, the skin, bones, fat, and muscles in our faces begin to thin and shift. These changes result in facial wrinkles, folds, laxity, and/or loss of volume. Injectable calcium hydroxylapatite (CaHA) filler, Radiesse, is a biocompatible, dermal filler which is FDA approved to improve the appearance of moderate to severe facial wrinkles and folds, such as the nasolabial folds. It can also be used to improve the signs of facial fat loss associated with the HIV virus. CaHA is available with and without lidocaine. Lidocaine is an anesthetic used to reduce pain and improve patient comfort during the injection process.

First, your doctor marks the areas to be injected. Topical or injection numbing medication may be used for added comfort prior to your procedure. Next, CaHA is injected into the skin. CaHA produces immediate results and over time can also increase collagen production in the areas injected. The effects of injectable CaHA typically last about 12 months. After that time, additional injections are required to maintain the effects.

Before (left) and after (right) - Radiesse (cheeks, nasolabial folds, and marionette lines) and Belotero.

Photo courtesy of C. Burgess

Before (left) and after (right) Radiesse to nasolabial folds and marionette lines and Belotero (perioral) injection.

Photo courtesy of C. Burgess

Before (left) and after (right) radiesse to hands.

Photo courtesy of D. Friedmann

Who is not a candidate for injectable calcium hydroxylapatite?

CaHA is not recommended for patients who have:

  • Current oral herpes or a similar infection
  • Uncontrolled diabetes
  • Blood-clotting problems
  • An allergy to the ingredients of CaHA or a history of anaphylaxis
  • Patients whom are pregnant or breast-feeding


When is injectable calcium hydroxylapatite appropriate?

CaHA filler can be used to treat

  • Wrinkles
  • Nasolabial folds
  • Marionette lines
  • Pre-jowl sulcus
  • Chin lines

Where is injectable calcium hydroxylapatite not indicated for injection?

CaHA filler is not used for

  • Lips augmentation
  • Fine lines around the mouth
  • Under the eyes

Before (left) and after (right) - radiesse to hands.

Photo courtesy of J. Peterson

Before (left) and after (right) Radiesse to temples, midcheek, and madibular.

Photo courtesy of K. Butterwick

Before (left) and after (right) - 9 months after Radiesse

Photo courtesy of S. Fabi

What can I expect after having had injectable calcium hydroxylapatite?

Calcium hydroxylapatite is a temporary dermal filler, lasting anywhere from 12 month or more. Some patients require maintenance treatments to achieve the best results. Expectations differ following treatment:

  • Wrinkles and Folds: Bruising, which may last up to a week. Swelling. Redness. Following treatment, ice may be given to ease discomfort and swelling. Avoid applying firm pressure on the treatment area.
  • CaHA can be seen on X-ray films and Cat scans. If you are having a radiology procedure performed on your face, then you should tell your physician you have been previously injected with this product.

Is injectable calcium hydroxylapatite painful?

Topical numbing agents or anesthetic injections are sometimes applied to ease discomfort. Before and following treatment, ice may be given to ease discomfort and swelling. Patients should avoid applying firm pressure on the treatment area.

Possible Risks

Common side effects include:

  • Swelling
  • Bruising
  • Bleeding
  • Lumps and bumps
  • Redness

Uncommon side effects include:

  • Numbness
  • Allergic reactions
  • Infection
  • Blisters and cyst;
  • Inflammatory reactions
  • Migration of filler material to another site
  • Vascular occlusion
  • Scarring
  • Blindness