Radiesse® — Injection Techniques
BioForm Medical and the Radiesse® Medical Advisory Board have established some tips and recommended techniques to enhance your clinical use of Radiesse.
Points to note before injecting:
- Consult with the patient and identify area(s) to be injected using the Radiesse Treatment Planning Form.
- Obtain patient consent on the appropriate forms.
- Take photographs before and after injections.
- Provide some level of anesthesia (nerve block, topical anesthetic or ice). Note the maximum dosing of various injectable lidocaines.
- Use a non-permanent skin marker or white makeup pencil to mark areas to be treated (if necessary) with patient in an upright position.
- Prepare the skin with alcohol or a skin cleanser of choice.
- Open the Radiesse foil package and note that there should be a few moisture droplets inside, which is normal.
- Affix a 27 gauge needle to the Radiesse syringe and prime the needle; needle length is the injector's preference (1.25" or 0.5").
- Inject fine threads in multiple passes in a retrograde fashion into the deep dermis, or sub-dermal layers, depending on skin thickness and areas being injected; there is no need to remove the needle between threads.
- Placement of linear threads in a "stacking" manner under creases, or a "cross-fanning" manner to bolster areas of volume loss is common.
- Apply your antibiotic ointment of choice over the injected areas to minimize potential for infection.
- Massage and mold the injected areas to smooth over any subtle irregularities; be mindful where multiple products have been injected.
- Progressively bring the patient to full correction.
- Refer to the Radiesse Post Treatment Checklist for after-treatment care.
- Discard any unused product, as sterility cannot be guaranteed once the foil package is opened.
Nasolabial Folds — Linear Threading and Fanning
1.25" or 0.5" 27g Needle Recommended
- Insert needle into skin until you feel resistance in deep dermis/subdermal plane.
- Inject fine threads of Radiesse while withdrawing needle (retrograde).
- Inject parallel threads medial to the original Radiesse thread.
- If injecting a prominent crease, place material in a deeper plane to support the fold.
- Use fanning at perialar depression to bolster at dermal/subdermal junction.
- Massage and mold with thumb and forefinger as needed.
Marionette Lines — Fanning and Crosshatching
1.25" or 0.5" 27g Needle Recommended
- Insert needle medial to the marionette line until you feel resistance in deep dermis/subdermal plane.
- Use fanning technique with retrograde threading to fill and lift depression.
- Take precautions against injection of material in bolus fashion.
- Perpendicular to original threads, repeat injection resulting in crosshatching of material.
- Exercise caution in volume placed; progressively bring patient to optimal correction.
- Massage and mold with thumb and forefinger as needed.
Facial Lipoatrophy — Fanning, Linear Threading, and Crosshatching
1.25" 27g Needle Recommended
- Insert needle into the dermal/subcutaneous junction or subcutaneous space.
- Inject multiple threads of material using fanning technique to augment sub-malar area.
- Layer additional threads of Radiesse in a deeper plane. Use fanning technique at oblique angle to original threads to achieve desired correction.
- Expect major improvement with 1 to 2 ml per side.
- Massage and mold with thumb and forefinger as needed.