Treatment of the Face Using Calcium Hydroxyapatite 

Uncategorized Feb 12, 2024

Calcium hydroxyapatite (CaHa; Radiesse) is one of the most well studied dermal fillers worldwide and has been used to replenish lost facial volume and correct facial lines and folds. It's a must have product in every injectors practice due to its profound immediate and long-lasting effects in improving skin elasticity and laxity. Since its approval in 2006, Radiesse remains as the only FDA approved CaHA filler for facial augmentation and retains a well safety profile. Radiesse CaHA (+) is an opaque, semi solid, cohesive implant of 25-45μm CaHA microspheres suspended in a gel carrier of glycerin, sodium carboxymethylcellulose, 0.3% lidocaine hydrochloride, and sterile water. It is a semipermanent and biodegradable filler that is an effective stimulator of neocollagenesis in the face. 

So what makes CaHA so unique? 

Not only does CaHa filler restore volume loss almost immediately, but the injection stimulates a controlled inflammatory response that replaces the aqueous gel to a dense deposit of type 1 collagen. Type 1 collagen leads to improved mechanical properties of the skin rather than a fibrotic process produced by type 3 collagen. Studies show that even after its absorption by the body, soft tissue enlargement and dermal thickness is still visible. While Radiesse has been primarily used in the face, many practices are using Radiesse in its hyperdiluted form all over the body!

But, what are the benefits hyperdiluted CaHA? 

Diluting CaHA filler with saline or lidocaine removes the volumizing effect due to the carboxymethylcellulose gel dispersion. This allows for only CaHA microsphere tissue remodeling and dermal rejuvenation. Hyperdiluted CaHA allows for a larger surface area of the body to be treated and is usually used in parts of the body with thinner skin: 1:2 for normal skin, 1:4 for thin skin, and 1:6 for atrophic skin. Studies show that higher dilution of CaHA results in a greater weight and depth of spread and greater particle distribution. Product application can be performed by both short linear threading technique by needles or via retro injections (fanning or asterisk techniques) with a cannula. Common areas of treatment are mentioned below!

Areas of Treatment Include:

  • Upper and Lower Face 
  • Neck 
  • Decollete 
  • Hands
  • Knees 
  • Buttocks 
  • Thighs 

CaHA can be used almost everywhere on the body, but recent focus of CaHA filler has been on the lower face! As an injector, you must be up to date on the current uses of the product! 

CaHA in the Lower Face

CaHA has been used in the lower face for jawline contour and rejuvenation of the prejowl sulcus and providing definition to the gonial angle. Because CaHa (+) has high G’ and viscosity, it is a great product to place on the periosteum where it lifts the overlying tissue and retains shape.

For refining the jawline and minimizing the appearance of jowls, the preferred injection sites include the mandibular angle and the prejowl sulcus. CaHA should be strategically administered at the junction between the dermis and hypodermis or within the deep dermal layer. Augmenting the mandible area just below the masseter muscle, right above the periosteum at the mandibular angle, proves beneficial for both male and female patients. This technique addresses the diminished volume in the masseter and mandible concurrently resulting in a lower face lift effect. 

CaHA is the Key to Youth Restoration 

We are continually finding more innovative ways to use CaHA in other unconventional body areas and techniques to fully utilize its benefits. CaHA stands out as an exceptional choice for facial contouring due to its unique ability to stimulate natural collagen production, offering both immediate and lasting enhancements. Its biocompatibility ensures it integrates seamlessly with the body's tissues, minimizing risks of adverse reactions and promoting a natural-looking improvement. By providing structural support and fostering tissue regeneration, CaHA not only improves aesthetic outcomes but also enhances skin quality over time. Its versatility in addressing various aspects of facial aging, from volume loss to line reduction, makes it a cornerstone in aesthetic medicine. Ultimately, the use of CaHA represents a sophisticated blend of immediate aesthetic enhancement and long-term skin health benefits, making it an invaluable tool for achieving and maintaining youthful, radiant skin.


Try a free trial on us!

Sign up below for a sneak peak into Dr. Kay's Modern Aesthetic Theory course, featuring three popular modules:

Module 2 - Optimizing the Patient Experience

Module 3 - Anatomical Safety & Danger Zones

Module 22 - Neck Filler