NEWPORT BEACH, CALIF. What has a long track record of safety and is tailor-made for dermatologists wary of overcorrection? Radiesse, an injectable filler with a 30-year history of use in bone repair and dental work, Michael Churukian, M.D., said at a meeting sponsored by the Foundation for Facial Plastic Surgery.
"I have never had the courage to use a foreign body" to smooth and contour facial lines, explained Dr. Churukian, who practices in Beverly Hills, Calif. "I am a real sissy about it."
He added that 2 decades ago, after reports of hypersensitivity reactions from certain bulking agents, he decided to turn to a material he had seen used for skull restoration early in his medical career: Radiesse, which is manufactured by BioForm Medical Inc. and, until July 2004, was known as Radiance. It duplicates a naturally occurring mineral, and solid evidence suggests that it is incorporated into the surrounding tissue, then largely replaced by it, over several months' time, he said.
However, the reason for his increasing reliance on Radiesseaside from his own confidence in itcenters on meeting patient demand, Dr. Churukian said at the meeting, which was also sponsored by Medical Education Resources. Since the advent of collagen and, more recently, Botox, patients have gotten used to the idea of undergoing procedures intermittently. However, they have also become more discerning. They want a product that has a track record of effective, long-term use. Radiesse fits the bill: It has been injected into thousand of patients with no reports of serious adverse effects, and no pretesting of any kind is required, Dr. Churukian said.
"When I started out, there was only one thingcollagen," he said. "Now there are almost too many choices, all these different injectables."
"Everything works; that is not the issue," he said. However, he uses Radiesse to avoid the risk of an allergic reaction, and he injects the microspheres in such tiny increments that the chance of "overdoing it" is almost zero.
Using quantities tantamount to about half of the recommended volume enables him to do less, not more, than he intends. "You never know how exuberant that implant is going to be," he said. "Rather than go for a home run, go for a double."
A subtle result is more likely to guarantee returning patients, he said. "They see you, they trust you, they come back," he said. On the other hand, overcorrection can mean disappointment, and "they will tell their friends [and] family about that."
Most patients who undergo treatment can count on the fact that it will last about 2 years, although there is some variation, he said. There have been some minor complications, such as lumpiness around the injection site, but most of those results have been transient, he said. In addition, Dr. Churukian has largely limited his use of this filler to frown lines and other kinds of furrows, and has avoided attempting to enhance asymmetrical features or augment underlying facial structure.
Responses to 120 patient questionnaires over the past few years showed that most patients believed the treatment adequately improved their appearance, found the cost to be reasonable, and said they would recommend the treatment to their friends.