Calcium Hydroxyapatite for Face

  • Eliandre Costa Palermo
  • Alessandra Anzai


Calcium hydroxyapatite (CaHA, Radiesse® Merz Pharmaceuticals GmbH, Frankfurt, Germany) is a biostimulatory filler that provides immediate soft tissue augmentation and stimulates collagen production overtime. CaHA can be injected into the deep dermis, the subcutaneous tissue or supraperiosteally, and it can be diluted in different concentrations that gives a great versatility to the product. Its high viscosity limits the migration of the product, and its high cohesivity permits a high lifting capacity. It is also elastic and resistant to deformation under pressure. CaHa can be injected with needle or blunt cannula, and the technique varies according to the area and the plan of treatment. It is contraindicated in hypermobile areas with thin skin as lips, in perioral and periorbital region where there is an increased risk of nodule formation, and in the glabellar area and in the nose due to the risk of vascular occlusion.


Calcium hydroxylapatite CaHA Facial augmentation Filler Radiesse 


  1. 1.
    Sundaram H, Voigts B, Beer K, Meland M. Comparison of the rheological properties of viscosity and elasticity in two categories of soft tissue fillers: calcium hydroxylapatite and hyaluronic acid. Dermatol Surg. 2010;36:1859–65.CrossRefGoogle Scholar
  2. 2.
    Loghem JV, Yutskovskaya YA, Werschler P, Calcium Hydroxylapatite W. Over a Decade of Clinical Experience. J Clin Aesth Dermatol. 2015;8(1):38–49.Google Scholar
  3. 3.
    Kadouch JA. Calcium hydroxylapatite: a review on safety and complications. J Cosmet Dermatol. 2017;00:1–10.Google Scholar
  4. 4.
    Courderot-Masuyer C, Robin S, Tauzin H, Humbert P. Evaluation of lifting and antiwrinkle effects of calcium hydroxylapatite filler. In vitro quantification of contractile forces of human wrinkle and normal aged fibroblasts treated with calcium hydroxylapatite. J Cosmet Dermatol. 2016;15:260–8.CrossRefGoogle Scholar
  5. 5.
    Emer J, Sundaram H. Aesthetic applications of calcium hydroxylapatite volumizing filler: an evidence-based review and discussion of current concepts: (part 1 of 2). J Drugs Dermatol. 2013;12(12):1345–54.Google Scholar
  6. 6.
    Jacovella PF. Use of calcium hydroxylapatite (Radiesse®) for facial augmentation. Clin Interv Aging. 2008;3(1):161–74.Google Scholar
  7. 7.
    Graivier MH, Bass LS, Busso M, Jasin ME, Narins RS, Tzikas T. Calcium Hydroxylapatite (Radiesse) for correction of the mid-and lower face: consensus recommendations. Plast Reconstr Surg. 2007;120(6 Suppl):55S–66S.CrossRefGoogle Scholar
  8. 8.
    Yutskovskaya YA, Kogan EA. Improved neocollagenesis and skin mechanical properties after injection of diluted calcium hydroxylapatite in the neck and décolletage: a pilot study. J Drugs Dermatol. 2017;16(1):68–74.Google Scholar
  9. 9.
    Pavicic T. Complete biodegradable nature of calcium hydroxylapatite after injection for malar enhancement: an MRI study. Clin Cosmet Investig Dermatol. 2015;8:19.Google Scholar
  10. 10.
    Carruthers A, et al. Radiographic and computed tomographic studies of calcium hidroxylapatite for treatment HIV-associated facial lipoatrophy and corretion of nasolabial folds. Dermatol Surg. 2008;34:S78–84.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Eliandre Costa Palermo
    • 1
  • Alessandra Anzai
    • 2
  1. 1.Faculty of Medicine of the ABC Foundation, DermatologySão PauloBrazil
  2. 2.Hospital das Clínicas of University of São Paulo Medical School, DermatologySão PauloBrazil

Personalised recommendations