Radiesse

What is it?

Radiesse is an injectable filler that holds calcium hydroxylapatite (CaHA) microspheres in a carrier gel. Calcium hydroxylapatite is a compound also found in bone and tooth tissue.

It works in two stages: the carrier gel gives volume and support at the time of treatment, while the microspheres stimulate the tissue's own collagen production over time. For this reason it is classed not just as a volume filler but as a biostimulator.

The diluted form, applied for skin quality, is commonly known in Turkey as the “mineral injection”; that treatment is described on a separate page. This page describes the undiluted treatment used for volume and contour.

How does it work, and when is the result visible?

The fullness seen immediately after treatment is largely due to the carrier gel. As the gel is absorbed over the following weeks, the appearance may recede somewhat; the real result emerges over time as the collagen response develops. The appearance in the first days is not the final result.

It differs from hyaluronic acid fillers in two ways: the result settles over time rather than on the same day, and it cannot be dissolved with hyaluronidase. It is not the right choice for someone who wants an immediate and reversible change.

1. Treatment: the gel containing microspheres is placed in the target layer.
2. First period: the fullness seen is largely due to the carrier gel.
3. Transition: the gel is absorbed; the appearance may recede slightly.
4. Collagen response: the tissue response develops over weeks and determines the real result.

Animated Explainer

Treatment Areas

• Cheekbones — mid-face volume support
• Chin — contour and projection
• Jawline — definition of the line
• Backs of the hands — appearance due to volume loss
• What it cannot do: lips — this substance is not considered suitable for the lips
• What it cannot do: thin-skinned, superficial areas — risk of nodules

Procedure Steps

1. Assessment

   Rather than applying a standard protocol to everyone, skin quality, signs of ageing, the treatment area and your expectations are assessed first. The aim is not to do more procedures but to apply the right protocol, to the right patient, in the right area. If someone expects an immediate result, they are told at this stage that this treatment is not suitable for them.

2. Information on irreversibility

   It is explained clearly that the treatment cannot be dissolved with hyaluronidase. This is the most important point to know before deciding.

3. Preparation and treatment

   The area is cleaned with antiseptic and a topical anaesthetic is applied if needed. The product is placed at the appropriate depth in controlled amounts; superficial placement is avoided.

4. Follow-up

   The result is assessed over the following weeks. No decision is made on the basis of the early appearance; a top-up session is planned if needed.

Duration and Longevity

How long the effect lasts depends on the person, the area treated and the degree of collagen response; the ranges reported in the literature are wide and no fixed duration is given in advance. Regardless of duration, what needs to be known is this: the effect fading does not mean the gel can be dissolved. Irreversibility is a separate and more important feature than durability.

Who is it suitable for?

• Adults aiming for structural support in areas such as the cheekbones and jawline
• People who accept that the result settles over time
• People who come knowing and accepting that it cannot be reversed
• People expecting a realistic and limited change

Who is it not suitable for?

• Pregnant and breastfeeding people
• People with an active infection, a cold sore (herpes) flare or an open wound in the treatment area
• People with a bleeding disorder, and people taking blood thinners without their physician's approval
• People with an uncontrolled autoimmune disease
• Under 18s
• People expecting an immediate or reversible result
• People considering treatment of the lips — this substance is not considered suitable for the lips
• People who are undecided: with a treatment that cannot be undone, indecision is in itself a reason to postpone

Aftercare

• Do not apply pressure to or massage the area in the first days.
• For the first 24–48 hours, avoid alcohol and any blood thinners your physician has not approved.
• Stay away from hot environments and strenuous exercise in the first days.
• Allow weeks before assessing the result; the early appearance is not final.
• In case of increasing pain, blanching of the skin or a spreading colour change, contact the clinic without waiting.

Possible Side Effects

• Temporary swelling, redness and bruising
• A slight receding of the appearance in the early period — due to absorption of the carrier gel
• Palpable firmness or nodules — reported particularly with superficial placement
• Asymmetry — the options for correction are more limited than with hyaluronic acid fillers
• Rare but serious: filler blocking a blood vessel. Because there is no enzyme to reverse it, this situation is harder to manage than with hyaluronic acid fillers.

Frequently Asked Questions

References

• Kadouch JA. Calcium hydroxylapatite: A review on safety and complications. J Cosmet Dermatol. 2017
• Amiri M et al. Skin regeneration-related mechanisms of Calcium Hydroxylapatite (CaHA): a systematic review. Front Med (Lausanne). 2023
• van Loghem J et al. Managing intravascular complications following treatment with calcium hydroxylapatite: An expert consensus. J Cosmet Dermatol. 2020