Calcium Hydroxylapatite to Treat the Face

  • Gabriela CasabonaEmail author
  • Mauricio Shigueru Sato
Living reference work entry

Latest version View entry history

Part of the Clinical Approaches and Procedures in Cosmetic Dermatology book series (CAPCD)


Face rejuvenation is a wide concept and involves not only, but mostly, volume restoration of mainly fat and bone. With aging, subdermal fat and dermis thickness diminish at the extremities, and in the face, the dermis thickens and loosens. Many different fillers can be used to restore facial volume, and each of them has advantages and disadvantages. In this chapter, we describe the use of calcium hydroxylapatite (CaHa) as a secure and effective product to be used to not only restore volume but also stimulate neocollagenesis.


Calcium hydroxylapatite Fillers Volume restoration Biostimulation Neocollagenesis 


  1. Bass LS, Smith S, Busso M, McClaren M. Calcium hydroxylapatite (RADIESSE) for treatment of nasolabial folds: long-term safety and efficacy results. Aesthet Surg J. 2010;30(2):235–8. (Bass 2010).CrossRefGoogle Scholar
  2. Becker H. Nasal augmentation with calcium hydroxylapatite in a carrier-based gel. Plast Reconstr Surg. 2008;121:2142–7.CrossRefGoogle Scholar
  3. Berlin AL, Hussain M, Goldberg DJ. Calcium hydroxylapatite filler for facial rejuvenation: a histologic and immunohistochemical analysis. Dermatol Surg. 2008;34(Suppl 1):S64–7.PubMedGoogle Scholar
  4. Bernardini FP, Cetinkaya A, Devoto MH, Zambelli A. Calcium hydroxyl-apatite (Radiesse) for the correction of periorbital hollows, dark circles, and lower eyelid bags. Ophthal Plast Reconstr Surg. 2014;30(1):34–9.CrossRefGoogle Scholar
  5. Broder KW, Cohen SR. An overview of permanent and semipermanent fillers. Plast Reconstr Surg. 2006;118(3 Suppl):7S–14S.CrossRefGoogle Scholar
  6. Carruthers A et al. A validated brow positioning grading scale. Dermatol Surg. 2008a;34(Suppl 2):S150–4.PubMedGoogle Scholar
  7. Carruthers A et al. A validated grading scale for marionette lines. Dermatol Surg. 2008b;34(Suppl 2):S167–72.PubMedGoogle Scholar
  8. Carruthers A et al. A validated grading scale for crow’s feet. Dermatol Surg. 2008c;34(Suppl 2):S173–8.PubMedGoogle Scholar
  9. Casabona G. Blood aspiration test for cosmetic fillers to prevent accidental intravascular injection in the face. Dermatol Surg. 2015;41(7):841–7.CrossRefGoogle Scholar
  10. Casabona G, Michalany N. Microfocused ultrasound with visualization and fillers for increased neocollagenesis: clinical and histological evaluation. Derm Surg. 2014;40:12s.CrossRefGoogle Scholar
  11. Dayan SH, Greene RM, Chambers AA. Long-lasting injectable implant for correcting cosmetic nasal deformities. Ear Nose Throat J. 2007;86:25–6.PubMedGoogle Scholar
  12. Drobeck HP, Rothstein SS, Gumaer KI, Sherer AD, Slighter RG. Histologic observation of soft tissue responses to implanted, multifaceted particles and discs of hydroxylapatite. J Oral Maxillofac Surg. 1984;42:143.CrossRefGoogle Scholar
  13. Fitzgerald R, Rubin A. Filler placement and the fat compartments. Dermatol Clin. 2014;32:37–50.CrossRefGoogle Scholar
  14. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 2013a 12(6): 295–316. (Funt 2013)Google Scholar
  15. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol. 2013;6:295–316.PubMedPubMedCentralGoogle Scholar
  16. Hinderer UT, de Rio Lagarreta. Aesthetic surgery of the Malar region. In: Regnault P, Daniel R, editors. Aesthetic plastic. Boston: Little Brown; 1984.Google Scholar
  17. Hirsch RJ, Stier M. Complications of soft tissue augmentation. J Drugs Dermatol. 2008;7(9):841–5.Google Scholar
  18. Humphrey C, Arkins J, Dayan S. Soft tissue fillers in the nose. Aesthet Surg J. 2009;29:477.CrossRefGoogle Scholar
  19. Jacovella PF, Peiretti CB, Cunille DR, et al. Long lasting results with hydroxylapatite facial filler. Plast Reconstr Surg. 2006;118:15S–21S.CrossRefGoogle Scholar
  20. Jansen D, Graivier M. Evaluation of a calcium hydroxylapatite–based implant (Radiesse) for facial soft-tissue augmentation. Plast Reconstr Surg. 2006;118(Suppl):22S.CrossRefGoogle Scholar
  21. Lambros V. Personal communication, July 2006.Google Scholar
  22. Lee J, Kim L. Foreign body granulomas after the use of dermal fillers: pathophysiology, clinical appearance, histologic features, and treatment. Arch Plast Surg. 2015;42(2):232–9.CrossRefGoogle Scholar
  23. Lemperle G, Morhenn V, Charrier U. Human histology and persistence of various injectable filler substances for soft tissue augmentation. Aesthet Plast Surg. 2003;27:354.CrossRefGoogle Scholar
  24. Loghem V, Yutskovskaya Y, Werschler P. Calcium hydroxylapatite over a decade of clinical experience. J Clin Aesthet Dermatol. 2015;8(1):38–49.PubMedPubMedCentralGoogle Scholar
  25. Loghem J, Yutskovska YA, Werschler P. Calcium hydroxylapatite – over a decade of clinical experience. J Clin Aesthet Dermatol. 2015;8(1):38–49. (Van Loghem et al. 2015).PubMedPubMedCentralGoogle Scholar
  26. Marmur ES, Phelps R, Goldberg DJ. Clinical, histo-logic and electron microscopic findings after injection of a calcium hydroxylapatite filler. J Cosmet Laser Ther. 2004;6:223.CrossRefGoogle Scholar
  27. Murray CA, Zloty D, Warshawski L. The evolution of soft tissue fillers in clinical practice. Dermatol Clin. 2005;23:343–63.CrossRefGoogle Scholar
  28. Narins RS, Bowman PH. Injectable skin fillers. Clin Plast Surg. 2005;32:151.CrossRefGoogle Scholar
  29. Pavicic T. Calcium hydroxylapatite filler: an overview of safety and tolerability. J Drugs Dermatol. 2013;12(9):996–1002. (Pavicic 2013).PubMedGoogle Scholar
  30. Pellacani G, Seidenari S. Variations in facial skin thickness and echogenicity with site and age. Acta Dermatol Venereol. 1999;79:366.CrossRefGoogle Scholar
  31. Radiesse Datasheet. Available at: Accessed January 2, 2006.
  32. Rohrich R, Pessa J. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. 2007;119:2219.CrossRefGoogle Scholar
  33. Sadick NS, Katz BE, Roy D. A multicenter, 47-month study of safety and efficacy of calcium hydroxylapatite for soft tissue augmentation of nasolabial folds and other areas of the face. Dermatol Surg. 2007;33(Suppl 2):S122–6. discussion S126–7.PubMedGoogle Scholar
  34. Sclafani AP, Fagien S. Treatment of dermal filler complications. Dermatol Surg. 2009;35(Suppl 2): 1672–80. E. G. Busso M, Applebaum D. Hand augmentation with Radiesse (Calcium hydroxylapatite). Dermatol Therapy. 2007;20:385–7 (Busso, 2007) i. Sadick NS. A 52-week study of safety and efficacy of calcium hydroxylapatite for rejuvenation of the aging hand. J Drugs Dermatol. 2011;10(1):47–51 (Sadick 2011).Google Scholar
  35. Shaw R et al. Aging of the facial skeleton: aesthetic implications and rejuvenation strategies. Plast Reconstr Surg. 2011;127:374.CrossRefGoogle Scholar
  36. Smith S, Busso M, McClaren M, Bass LSA. Randomized, bilateral, prospective comparison of calcium hydroxylapatite microspheres versus human-based collagen for the correction of nasolabial folds. Dermatol Surg. 2007;33:112–21. (Smith 2007).CrossRefGoogle Scholar
  37. Stupak HD, Moulthrop TH, Wheatley P, Tauman AV, Johnson Jr CM. Calcium hydroxylapatite gel (Radiesse) injection for the correction of postrhinoplasty contour deficiencies and asymmetries. Arch Facial Plast Surg. 2007;9:130–6.CrossRefGoogle Scholar
  38. Tzikas TL. A 52-month summary of results using calcium hydroxylapatite for facial soft tissue augmentation. Dermatol Surg. 2008;34(Suppl 1):9–15.Google Scholar
  39. Voigts R, Devore DP, Grazer JM. Dispersion of calcium hydroxylapatite accumulations in the skin: animal studies and clinical practices. Dermatol Surg. 2010;36(Suppl s1):798–803.CrossRefGoogle Scholar
  40. Yutskovskaya Y, Kogan E, Leshunov E. A randomized, split-face, histomorphologic study comparing a volumetric calcium hydroxylapatite and a hyaluronic acid-based dermal filler. J Drugs Dermatol. 2014;13(9):1047–52.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Clinica Vida – Cosmetic, Laser and Mohs Surgery CenterSão PauloBrazil
  2. 2.Mohs Surgeon at Hospital das ClinicasCuritibaBrazil

Personalised recommendations