As of March 2015, RADIESSE® (+) was FDA approved to replace RADIESSE® Volumizing Filler. The difference is that RADIESSE® (+) comes pre-mixed with 0.3% powdered lidocaine. This difference provides a significantly more comfortable treatment experience with the same correction properties as before.
RADIESSE® (+) is manufactured by MERZ AESTHETICS™ and is an opaque dermal filler that contains calcium-based microspheres suspended in a water-based gel carrier. As it contains no animal proteins, it does not require allergy pre-testing. This product works in two ways. The gel carrier gives an immediate correction. The calcium-based microspheres act as a scaffold, stimulating your body to produce its own natural collagen. Over time, the gel carrier is absorbed and the calcium-based microspheres are metabolized by your body, leaving behind the newly created collagen. A treatment with RADIESSE® (+) may result in a correction lasting a year or longer.
RADIESSE® (+) can be used in multiple areas. It can be injected deeply to lift and augment the cheeks, temples, chin and pre-jowl area. It can be injected more superficially for nasolabial folds, marionette lines and chin creases.
In February 2015, RADIESSE® (+) received FDA Panel Approval for Hand Augmentation. It is an ideal product to inject under the skin of the dorsal surface of the hands to give them a more youthful appearance. The FDA approved treatment with RADIESSE® Volumizing Filler for Facial Lipoatrophy associated with HIV. This topic will be discussed in its own section.
RADIESSE® (+) has the same precautions as other dermal fillers with a three exceptions. The calcium-based microspheres are visible on CT scans and may be visible in standard plain radiography. It is advised to tell your treating physician or radiologist that you have had RADIESSE® (+) injected in your face before any radiological studies are preformed. The second precaution is that RADIESSE® (+) has been known to activate herpes simplex in patients with a history of herpes simplex. It is not recommended to pre-treat for this condition, but treatment should be started if any symptoms arise after an injection procedure. The third precaution is that RADIESSE® (+) should not be injected around the eyes or in the lips as the formation of nodules may occur in these areas.
We’re gonna do this with Radiesse® and this is our product, see it? And here’s our syringe, right. So see these little groove here, here and here, and in here. So I’m going to put a little burst of product in here, in here and in here. I’m going to go around so I don’t hit the vein, and just under the skin. See that pop in there. It’s going to look like a bolus of products, it’s going to sit there for right now. I’m going to come back and I’m going to move it around. It’s pretty simple because you just you can see everything everything because the skin of your hand is thin, and I can make sure I’m not hitting anything. So if I was injecting and I saw one of these blue veins start to look different I would know I’m having a problem right so I wouldn’t keep injecting there. I’m going to put a little bit more right down here. Okay, so there’s our syringe. Now we’re going to do is we’re going to massage it in. Now, see how it moves around. You want to keep a gentle even pressure on them. All ready. See the difference? Yeah, definitely. Now, when I come back at five-thirty, we’ll take a look at it and we’ll show, you give it another massage. So your hand might need more than one syringe? Yeah. But you wouldn’t really necessarily do two syringes, right away. No. So, you would think about waiting a little bit and coming back before it’s all gone and then adding a little bit more on top of here. so you do it in stages. Four and a half hours, so, how would you describe that hand now? Seventy-five percent improvement I’d say. Okay, so you think you still need more in there? Maybe. A little bit more. Okay. So we talked maybe down the road you might come back for a little more? Yeah. Okay. So, now this hand, so we still think it’s around a three to four grade right somewhere between. Okay and you ready? Yes, I’m ready. we’re using the same product, RADIESSE Plus. I didn’t even feel that. See how that actually not just stays in the hollow here, but it goes over the the tendon a little bit, too. So, see here this is right up to here, so, I’m going to go down here to inject it so don’t get near that vein. If I can get my needle in here. Going to get some more in here. You can’t clearly see where that vein is, totally miss it. What will happen if you went through a vein? You do not want to put a product in the vein because it was a plop to vein. And now, we basically just smooth it out. How’s that look? That’s good, but you know what this one improve at the afternoon. As it sat you look a little bit better? Yes. So now we know what it looked like right away and four hours later you’re saying it even looked a little bit better. Yes. Good so now we have a before both and an after one, after several hours, the second one to compare to right away, and probably I should ask you to come back in next week? Are you to come in for a shot? Probably, yeah. Then we’ll do another little quick shot of this so we can have look at it like a week later see how they looked in.
The most common adverse reactions to RADIESSE® (+) include swelling, allergic reaction, infection and local tissue damage or necrosis. Swelling for a few days after a treatment is very common and usually resolves within a few days with periodic icing. However, it has been reported to start up to 3 weeks later. This delayed swelling may require treatment with antibiotics, anti-histamines and steroids. An allergic reaction to the water-based gel carrier has been identified which may require treatment with anti-histamines and steroids. Infection is most commonly associated with pain, redness, hardened areas and pustules. The onset of infection has been reported up to 2 months after a treatment and would require antibiotic therapy. Necrosis of skin tissue would be the most problematic adverse reaction. It could be caused by an occlusion of the blood supply to the skin and present as blanching, tingling, bruising, redness or swelling of the treated area. RADIESSE® (+) cannot be dissolved with an enzyme unlike hyaluronic acid dermal fillers. Treatment for suspected necrosis includes nitroglycerin ointment for vasodilation of occluded blood vessels, pain management, antibiotics, non-steroidal wound ointments and warm compresses.
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