The Differences of Cosmetic Fillers Radiesse and Voluma, Where they are Used, and Safety Concerns

The Differences of Cosmetic Fillers Radiesse and Voluma, Where they are Used, and Safety Concerns

Thank you for your question. Your question
which was submitted without a photo is about this safety about using Radiesse to, I assume,
to further enhance the appearance of your cheeks after you already received Voluma which
was recommended by your doctor. Well certainly, I can give you guidance as
to my opinion about these fillers as well as the safety concern and the approach. I’m
a board certified cosmetic surgeon and fellowship trained oculofacial plastic and reconstructive
surgeon practicing in Manhattan and Long Island for over 20 years and I can certainly share
with you a lot of experience from using fillers over this time frame. I recall using the first
filler which was a collagen which was called Zyderm and Zyplast and certainly in the modern
world, we have a lot of options for filling different areas of volume loss. So understanding
what the concept is of the use of fillers in the midface is very important and understanding
structure. Chances are you are losing volume and as part of normal facial aging or you
want to enhance volume in an area where you want augment and just accentuate. Well, I think that it is fair to conclude,
again without photos where I would see what you look like before, what you look like after
and then give you some opinion but also in the absence of physical examination, here
are my thoughts about the interchangeability or the sequence. First of all, I don’t think
your doctor will consider doing Radiesse on top of Voluma. If your doctor felt it is not
safe so I don’t think that you need to second guess your doctor about safety. I think that
you will get a lot of opinions about safety but in the end, the most important thing is
to avoid risk of infections, inflammation but the more frequently issue is getting the
correction or the desired result or having problems with irregularities and unevenness. So when you look at the anatomy of your face
and you see how traditional fillers are placed, Voluma was a milestone in the development
of fillers because this was highly risked hyaluronic acid filler that was approved for
the use in the mid-face. It also has other properties that are advantageous. So to treat
the midface, there was, Allogen got the FDA approval for Voluma and that’s significant.
But as I observed for many years in practice, first with mid-face lifting and then soft
tissue augmentation is that the cheek pad or the malar fat pad where this material is
being placed provides us anatomically some limitations. So what you may see is an under
correction maybe because the material is diffusing in because you need a lot of volume as well
as the possibility that the skin itself is sagging. When you put a certain amount of
volume in the soft tissue of the cheek, you really are relying on the tone of the skin
as well as the ability of the underlying structure to maintain the position of the volume that’s
being placed. So when people walk in Manhattan with these giant cheeks, it’s often because
the doctor is compensating for sagging by over inflating. So the question of adding
Radiesse may still be valid or the reason for may still be valid because your doctor
might just want to add a little bit more material but something that is a little bit more viscous.
There is no question that the density of Radiesse is a little higher than Voluma but it is different
type of filler. It is a suspension of fine particles of calcium hydroxyapatite and it
is thicker. In our practice, what we do for this area
is something called structural volumizing and what we are doing is instead of placing
the material in the cheek level in the soft tissue, we are actually putting it on the
bone structure. And when placed on the bone structure, we actually have more of a solid
foundation to which we build up the structure of the cheek. We can put multiple syringes
of fillers such as Voluma or Juvederm Ultra Plus in this area and get that high accentuated
cheek and the material will not slide downward and it will not dissipate and it will actually
settle in and will look very nice. Now, I think that it can be a strategy for
you but understanding that essentially, the strategy your doctor is offering you has a
value but discuss with your doctor what kind of outcome can be realistically expected from
this type of strategy because you have to use a fair amount of material to keep adding
to this. And also get an explanation to why the doctor wanted to use Radiesse on top of
Voluma and why not use more Voluma. Could it be because you are metabolizing it? Could
it be because it’s just not reaching the level of correction? Clarity and communication is very important
but also understanding the concept is also critical. When someone doesn’t want to use
fillers and wants something more permanent, cheek implants are fantastic solutions for
filling out this area. But in the modern world, when people have less time, I also find that
using fillers has a very significant role in my kind of practice because I’m able
to really sculpt the fillers in a way I can’t do with cheek implants with the same level
of accuracy. But again, this is a question that’s on a different category of surgery
versus fillers. So I hope that was helpful, I wish you the
best of luck and thank you for your question!

About the Author: Earl Hamill


  1. Can you please explain metabolizing volume? Why in some people Voluma or Juvederm doesn't last. Is it migrating? Or being absorbed. Should I try more filler or will the same thing happen?

  2. Thank you for explaining this. I got Radiesse injected yesterday and I don’t like the hard cheekbone look. I wanted to enhance the apples of my cheeks and a softer look, like I did in the past with voluma, but my injector recommended radiesse. What is the best way to help the body get rid of the Radiesse since I know it’s not reversible? Thank you!

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