What Is Radiesse?
Radiesse is an FDA-approved injectable dermal filler manufactured by Merz Aesthetics. It is the first and only filler in the United States made of calcium hydroxylapatite (CaHA) — a biocompatible mineral compound that is naturally found in human bones and teeth.
Unlike hyaluronic acid (HA) fillers such as Juvederm or Restylane that add volume through hydration, Radiesse works through a dual-action mechanism: it provides immediate volume correction and stimulates your body's own collagen production over time. This makes Radiesse both a dermal filler and a biostimulator.
Key Facts About Radiesse:
- Active Ingredient: Calcium Hydroxylapatite (CaHA) microspheres (25-45 microns)
- Carrier Gel: Sodium carboxymethylcellulose (CMC) — approximately 30% CaHA, 70% gel
- Manufacturer: Merz Aesthetics (Germany)
- FDA Approvals: Facial wrinkles/folds (2006) + Hand rejuvenation (2015)
- Contains: Integrated lidocaine for patient comfort
- Duration: 12-18 months (longer than most HA fillers)
- In Use Since: Mid-1990s (25+ years of clinical history)
How Radiesse Works: Dual-Action Mechanism
What makes Radiesse unique among dermal fillers is its two-phase mechanism of action. It delivers results in two distinct stages:
🌱 Phase 2: Collagen Stimulation
Over 2-6 months, the CaHA microspheres create a scaffold that stimulates neocollagenesis — your body produces new collagen and elastin around the particles. The gel gradually absorbs, replaced by your own tissue.
This dual mechanism means that even as the gel carrier is absorbed by the body (typically within 2-3 months), the newly formed collagen maintains the volume and structural support. The CaHA microspheres themselves are gradually metabolized into calcium and phosphate ions — minerals your body naturally uses.
Why CaHA Is Special: Calcium hydroxylapatite has the highest G' (elastic modulus) of any injectable filler, meaning it provides superior lifting capacity and structural support. This makes Radiesse ideal for areas requiring strong projection like the jawline, chin, and cheeks.
Treatment Areas & Syringe Guide
Radiesse is FDA-approved for facial wrinkles/folds and hand rejuvenation. It is also widely used off-label for several other areas. Here are the most common treatment zones:
💪
Cheeks
1-2 syringes per side
Duration: 12-18 months
$650-$1,700
⚪
Jawline
2-4 syringes total
Duration: 12-15 months
$1,300-$3,400
☝
Chin
1-2 syringes
Duration: 12-18 months
$650-$1,700
🙂
Nasolabial Folds
1-2 syringes
Duration: 12-18 months
$650-$1,700
😞
Marionette Lines
1-2 syringes
Duration: 10-15 months
$650-$1,700
✋
Hands (FDA-Approved)
2-3 syringes per hand
Duration: 10-12 months
$1,300-$2,550
👀
Temples
1-2 syringes per side
Duration: 12-15 months
$650-$1,700
👃
Pre-Jowl Sulcus
1-2 syringes
Duration: 12-15 months
$650-$1,700
👅
Nose (Non-Surgical)
0.5-1 syringe
Duration: 12-18 months
$650-$850
⚠ Areas to AVOID with Radiesse: Radiesse should NOT be injected into the lips, under-eye area (tear troughs), or glabella (between the eyebrows). These areas have thin skin and high vascularity, increasing the risk of nodule formation and vascular complications. Use hyaluronic acid fillers for these zones instead.
Syringe Count by Treatment Goal
| Treatment Goal |
Typical Syringes |
Estimated Cost |
Sessions |
| Cheek Volume Restoration | 2-4 syringes | $1,300-$3,400 | 1 |
| Jawline Definition | 2-4 syringes | $1,300-$3,400 | 1-2 |
| Chin Augmentation | 1-2 syringes | $650-$1,700 | 1 |
| Nasolabial Fold Correction | 1-2 syringes | $650-$1,700 | 1 |
| Hand Rejuvenation (both) | 4-6 syringes | $2,600-$5,100 | 1 |
| Temple Hollowing | 2-4 syringes | $1,300-$3,400 | 1 |
| Non-Surgical Rhinoplasty | 0.5-1 syringe | $650-$850 | 1 |
| Full Face Rejuvenation | 4-8 syringes | $2,600-$6,800 | 1-2 |
Hyperdilute Radiesse for Skin Quality
Hyperdilute Radiesse is an advanced injection technique where Radiesse is diluted with saline and lidocaine to create a thinner solution. Instead of providing volume, the diluted product is spread over larger areas to act purely as a biostimulator — improving skin quality, texture, and firmness by stimulating collagen and elastin production.
Dilution Ratios & Uses
1:1
Facial Volume + Stimulation
Maintains some filling capacity while adding biostimulatory benefits. Best for face and temples.
1:2
Face, Neck & Décolletage
Balanced approach for moderate skin laxity. Covers larger facial zones and upper chest area.
1:4
Body (Arms, Abdomen, Knees)
Maximum spread for large body areas. Purely biostimulatory with no volume effect.
Hyperdilute Radiesse Treatment Areas
| Treatment Area |
Dilution Ratio |
Syringes |
Sessions Needed |
Cost/Session |
| Face (Full) | 1:1 to 1:2 | 1-2 | 2-3 | $800-$1,200 |
| Neck | 1:2 | 1-2 | 3 | $800-$1,200 |
| Décolletage (Chest) | 1:2 | 2-3 | 3 | $1,200-$1,800 |
| Upper Arms | 1:4 | 2-4 | 3 | $1,200-$2,000 |
| Abdomen | 1:4 | 3-6 | 3 | $1,500-$2,500 |
| Above Knees | 1:4 | 2-3 | 3 | $1,200-$1,800 |
| Buttocks | 1:2 to 1:4 | 4-8 | 3 | $2,000-$3,500 |
How Hyperdilute Radiesse Is Administered: The diluted solution is injected using a blunt-tip cannula (not a needle) in a retrograde fanning technique. The cannula distributes the product evenly across the treatment zone at the appropriate dermal depth. A minimum of 3 sessions spaced 4-6 weeks apart is recommended, with peak collagen production occurring 3-6 months after the final session.
Radiesse vs. Sculptra: Biostimulator Comparison
Radiesse and Sculptra are the two leading biostimulatory fillers — both stimulate collagen production, but they differ significantly in composition, mechanism, onset, and ideal use cases.
| Feature |
Radiesse |
Sculptra |
| Active Ingredient | Calcium Hydroxylapatite (CaHA) | Poly-L-Lactic Acid (PLLA) |
| Manufacturer | Merz Aesthetics | Galderma |
| FDA Approvals | Facial folds (2006) + Hands (2015) | Facial fat loss (2004) |
| Immediate Volume | ✅ Yes — instant correction | ❌ Minimal — gradual results |
| Collagen Stimulation | ✅ Yes (neocollagenesis) | ✅ Yes (neocollagenesis) |
| Onset of Full Results | Immediate + improves over 2-3 months | Gradual over 2-6 months |
| Duration | 12-18 months | 2-3 years (with full series) |
| Sessions Required | 1-2 sessions | 2-3 sessions (4-6 weeks apart) |
| Syringe Volume | 1.5 mL per syringe | 5 mL per vial (after reconstitution) |
| Cost per Session | $650-$850/syringe | $700-$1,200/vial |
| Total Treatment Cost | $1,300-$3,400 | $2,100-$3,600 |
| Hand Rejuvenation | ✅ FDA-approved | ❌ Not approved |
| Hyperdilute Option | ✅ Yes (skin quality) | ✅ Yes (skin quality) |
| Can Be Dissolved | ❌ Not enzymatically (STS off-label) | ❌ No |
| Post-Treatment Massage | Not required | 5-5-5 Rule (5 min, 5x/day, 5 days) |
| Lifting Capacity (G') | Highest of all fillers | Minimal lifting |
| Best For | Structural support, jawline, cheeks, hands | Gradual volume, temples, full face |
Choose Radiesse if: You want immediate results with structural lifting (jawline, cheeks, chin), need hand rejuvenation, or prefer fewer treatment sessions.
Choose Sculptra if: You want the longest-lasting results (2-3 years), prefer gradual natural-looking changes, or are treating large areas of facial volume loss.
Radiesse vs. Juvederm & HA Fillers
The most common question patients ask is whether to choose Radiesse or a hyaluronic acid (HA) filler like Juvederm. Here's a comprehensive comparison:
| Feature |
Radiesse (CaHA) |
Juvederm / HA Fillers |
| Composition | Calcium Hydroxylapatite | Hyaluronic Acid |
| How It Works | Volume + Collagen stimulation | Volume through hydration |
| Immediate Results | ✅ Yes | ✅ Yes |
| Collagen Stimulation | ✅ Yes | ❌ Minimal |
| Duration | 12-18 months | 6-18 months (varies by product) |
| Dissolvable | ❌ No (not enzymatically) | ✅ Yes (hyaluronidase) |
| Lip Use | ❌ NOT safe for lips | ✅ Ideal for lips |
| Under-Eye Use | ❌ NOT recommended | ✅ Select products (Restylane) |
| Lifting Capacity | High (highest G' value) | Moderate (varies by product) |
| Cost per Syringe | $650-$850 | $500-$900 |
| Visibility on Imaging | Visible on X-ray/CT scans | Not visible on imaging |
| Best For | Cheeks, jawline, chin, hands | Lips, under-eyes, cheeks, NLF |
Important Note: Radiesse is radiopaque — it shows up on X-rays, CT scans, and other medical imaging. This is not harmful, but patients should inform their radiologist about Radiesse injections to avoid misinterpretation. The visibility typically resolves as the product is metabolized (within 18-24 months).
Results Timeline: What to Expect
Here's a realistic timeline of what patients experience after Radiesse treatment:
0
Day of Treatment
Immediate volume correction visible. Mild swelling and redness at injection sites. The gel carrier provides instant lifting — you'll see results right away.
1-3
Days 1-3
Peak swelling occurs within 24-48 hours. Minor bruising may appear. The treated area may feel firm. Swelling typically subsides within 3-5 days.
1-2w
Weeks 1-2
Swelling fully resolves. Results settle into their final position. The treatment area feels natural to the touch. You see the true immediate result.
1-3m
Months 1-3
Collagen stimulation begins. The gel carrier gradually absorbs while new collagen forms around the CaHA microspheres. The transition from filler to your own collagen begins.
3-6m
Months 3-6
Peak collagen production. The gel carrier has mostly been absorbed. New collagen and elastin now provide the structural support. Skin quality improvements become most apparent during this phase.
12-18
Months 12-18
Results begin to gradually fade as the CaHA microspheres are metabolized and collagen naturally turns over. Most patients schedule maintenance treatments at 12-15 months.
Learn to Inject Dermal Fillers
Get hands-on training with Radiesse, Juvederm, Restylane, and other dermal fillers from board-certified instructors in small group settings.
View Filler Training Courses →
Cost & Pricing
Radiesse is competitively priced among premium dermal fillers. Here's a comprehensive pricing breakdown:
Cost by Treatment Area
| Treatment Area |
Syringes Needed |
Cost Range |
Maintenance Frequency |
| Nasolabial Folds | 1-2 | $650-$1,700 | Every 12-18 months |
| Cheeks | 2-4 | $1,300-$3,400 | Every 12-18 months |
| Jawline | 2-4 | $1,300-$3,400 | Every 12-15 months |
| Chin | 1-2 | $650-$1,700 | Every 12-18 months |
| Marionette Lines | 1-2 | $650-$1,700 | Every 10-15 months |
| Temples | 2-4 | $1,300-$3,400 | Every 12-15 months |
| Hands (Both) | 4-6 | $2,600-$5,100 | Every 10-12 months |
| Non-Surgical Rhinoplasty | 0.5-1 | $650-$850 | Every 12-18 months |
Radiesse vs. Other Fillers: Cost Comparison
| Product |
Cost/Syringe |
Duration |
Annual Cost (Cheeks) |
| Radiesse | $650-$850 | 12-18 months | $1,300-$2,550 |
| Juvederm Voluma | $700-$900 | 12-24 months | $1,400-$1,800 |
| Restylane Lyft | $600-$800 | 9-12 months | $1,200-$2,400 |
| RHA 4 | $700-$900 | 12-15 months | $1,400-$2,700 |
| Sculptra (per vial) | $700-$1,200 | 24-36 months | $700-$1,200 |
Merz Rewards Program: Radiesse is covered by the Merz Aesthetics Xperience+ loyalty program. Patients can earn points on Radiesse treatments and save on future sessions. Ask your provider about enrollment — it can reduce your annual cost by 10-20%.
Side Effects & Safety
Common Side Effects (Temporary)
Most side effects are mild and resolve within 1-7 days:
Swelling
Mild to moderate swelling at injection sites. Peaks at 24-48 hours. Usually resolves within 3-5 days. Apply ice intermittently.
Bruising
Minor bruising is common, especially in vascular areas. Typically fades within 5-10 days. Arnica cream may help speed resolution.
Redness
Temporary redness at injection sites lasting a few hours to 2-3 days. Completely normal and resolves on its own.
Tenderness / Firmness
The treated area may feel firm or tender for 1-2 weeks as the product settles. This gradually softens to feel natural.
Rare but Serious Complications
⚠ Vascular Occlusion: As with all injectable fillers, there is a rare risk of vascular occlusion (accidental injection into or compression of a blood vessel). Unlike HA fillers, Radiesse cannot be dissolved with hyaluronidase, making vascular events more challenging to manage. This is why Radiesse should only be injected by experienced, trained practitioners.
Other rare complications include:
- Nodules or lumps: Small, palpable bumps that may form if product is placed too superficially. More likely in thin-skinned areas (which is why lips and tear troughs are avoided).
- Asymmetry: Uneven results that may require additional product or time to resolve.
- Migration: Product moving from the injection site (rare with proper technique).
- Infection: Very rare. Signs include persistent redness, warmth, and pain beyond the first week.
Contraindications
Radiesse should NOT be used in patients with:
- Known allergy to any Radiesse components
- Active skin infections or inflammation at the injection site
- Bleeding disorders or currently on blood-thinning medications (relative contraindication)
- Severe allergies with a history of anaphylaxis
- Pregnancy or breastfeeding (not studied)
- History of keloid formation or hypertrophic scarring
Aftercare Instructions
Follow these guidelines for optimal Radiesse results and minimal side effects:
✅ Do
- Apply ice packs (10 min on, 10 min off) for 24-48 hours
- Sleep with your head elevated the first night
- Take Arnica supplements to reduce bruising
- Stay hydrated and eat anti-inflammatory foods
- Gently cleanse the treated area after 6 hours
- Use SPF 30+ sunscreen on treated areas
- Return for follow-up as recommended (2-4 weeks)
❌ Don't
- Touch, rub, or massage the treated area for 24-48 hours
- Exercise vigorously for 24-48 hours post-treatment
- Consume alcohol for 24 hours (increases bruising risk)
- Apply makeup for at least 4-6 hours post-injection
- Expose treated areas to extreme heat (sauna, hot yoga, steam rooms) for 2 weeks
- Schedule dental procedures for 2 weeks after facial injections
- Fly on an airplane for 24-48 hours (pressure changes can increase swelling)
Note About Massage: Unlike Sculptra, which requires the 5-5-5 massage rule (5 minutes, 5 times daily, for 5 days), Radiesse does NOT require post-treatment massage. In fact, excessive manipulation could cause product displacement. Leave the treated area alone and let it settle naturally.
Frequently Asked Questions
What is Radiesse made of?
+
Radiesse is made of calcium hydroxylapatite (CaHA) microspheres (approximately 30%) suspended in a sodium carboxymethylcellulose (CMC) gel carrier (approximately 70%). CaHA is a mineral compound naturally found in human bones and teeth, making it highly biocompatible. The microspheres are 25-45 microns in diameter and are completely smooth and round to minimize any tissue reaction.
How long does Radiesse last?
+
Radiesse typically lasts 12-18 months in most facial treatment areas, which is longer than most hyaluronic acid fillers. In the hands, results may last 10-12 months. The longevity depends on the treatment area, your metabolism, the amount injected, and your injector's technique. Maintenance treatments are typically scheduled at 12-15 month intervals.
How much does Radiesse cost?
+
Radiesse costs between $650-$850 per 1.5 mL syringe. Most facial treatments require 1-4 syringes depending on the area and desired result. Cheeks typically need 2-4 syringes ($1,300-$3,400), while nasolabial folds need 1-2 syringes ($650-$1,700). Hand rejuvenation requires 2-3 syringes per hand ($2,600-$5,100 for both). Hyperdilute Radiesse treatments range from $800-$1,500 per session.
What is the difference between Radiesse and Sculptra?
+
Both are biostimulatory fillers but differ in key ways. Radiesse (CaHA) provides immediate volume plus gradual collagen stimulation, requires 1-2 sessions, and lasts 12-18 months. Sculptra (PLLA) works primarily through gradual collagen stimulation with minimal immediate volume, requires 2-3 sessions, and lasts 2-3 years. Radiesse is FDA-approved for hands while Sculptra is not. Radiesse has higher lifting capacity (G') making it better for structural areas like jawline and chin.
Can Radiesse be dissolved?
+
Unlike hyaluronic acid fillers that can be dissolved with hyaluronidase, Radiesse cannot be enzymatically dissolved. Some practitioners use sodium thiosulfate (STS) off-label to help break down CaHA particles, but this is not a standard or FDA-approved reversal method. This is an important consideration — because Radiesse cannot be easily reversed, it should be injected conservatively by experienced practitioners.
Is Radiesse FDA-approved for hands?
+
Yes. In 2015, Radiesse became the first and only dermal filler to receive FDA approval specifically for hand rejuvenation. It is injected into the back of the hands to restore lost volume, reducing the visible appearance of tendons, veins, and bones that become prominent with aging. Typically 2-3 syringes are used per hand, with results lasting 10-12 months.
What is hyperdilute Radiesse?
+
Hyperdilute Radiesse is an advanced technique where the product is diluted with saline and lidocaine at ratios of 1:2 to 1:4. This creates a thinner solution used as a pure biostimulator rather than a volumizer. It's injected with a blunt-tip cannula across larger treatment areas (face, neck, chest, arms, abdomen) to stimulate collagen and elastin production for improved skin quality, texture, and firmness. A series of 3 treatments spaced 4-6 weeks apart is recommended.
Does Radiesse hurt?
+
Radiesse comes pre-mixed with lidocaine (a local anesthetic), which significantly reduces discomfort during injection. Most patients describe the sensation as a mild pinch or pressure. Many practitioners also apply topical numbing cream 20-30 minutes before treatment for additional comfort. On a pain scale of 1-10, most patients rate Radiesse injections a 3-4.
Is Radiesse safe for lips?
+
No — Radiesse should NOT be used in the lips. The lip tissue is too thin and highly vascular, which increases the risk of nodule formation and vascular complications. Additionally, because Radiesse cannot be dissolved, any complications in the lip area would be difficult to manage. Hyaluronic acid fillers like Juvederm Ultra, Restylane Kysse, or RHA 2 are the appropriate and safe choice for lip augmentation.
How is Radiesse different from Juvederm?
+
Radiesse (calcium hydroxylapatite) provides immediate volume plus long-term collagen stimulation, lasts 12-18 months, cannot be dissolved, and is NOT suitable for lips or under-eyes. Juvederm (hyaluronic acid) provides immediate volume through hydration, lasts 6-18 months depending on the product, CAN be dissolved with hyaluronidase, and IS safe for lips and under-eyes. Radiesse has higher lifting capacity, making it better for jawline and cheek contouring, while Juvederm offers more versatility across treatment areas.
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