7 min|Dr. Jordan Dutton

Hyaluronic Acid Fillers vs. Radiesse: Your Guide to Choosing the Right Dermal Filler

Beauty, Skin Health

When it comes to achieving youthful, plump, and wrinkle-free skin, dermal fillers have become a go-to solution for many, myself included! Two of the most popular options on the market are: hyaluronic acid fillers (such as Prollenium, Filmed, Stylage, Juvederm, Restylane, and Belotero) or Radiesse.

While both can provide excellent results, they work in distinct ways and are suited for different needs. In this blog, we’ll break down the key differences, benefits, and considerations to help you choose the right filler for your cosmetic goals.

What are Hyaluronic Acid Fillers?

Hyaluronic acid (HA) fillers are made of a naturally occurring substance found in the body called hyaluronic acid that helps maintain hydration and volume in the skin. These fillers are versatile and are commonly used to smooth wrinkles, add volume to the lips, contour the cheeks and jaw, fill in the temples contour the profile of the chin, lips and forehead, and address fine lines.

The hyaluronic acid is treated using a binder to create different density and viscosities, leading to differing effects when injected under the dermis (superficial) or supra-periosteal (deep). Once injected, hyaluronic acid fillers attract and bind water molecules, adding volume to the treated area instantly. They are soft, gel-like substances that, if done well, can provide a natural-looking result.

Often, I find people misuse the terms neuromodulators and filler due to misunderstanding the products. Neuromodulators (Botox) takes up to two weeks to see a difference whereas the benefits of HA fillers include:

Immediate Results: You can see the effects right after the procedure.

Natural Appearance: HA fillers are known for their smooth, natural look and feel.

Adjustability: Meaning, they are not permanent and if there is a complication can be dissolved using an enzyme called hyaluronidase if needed.

Minimal Downtime: The procedure is quick, with little to no recovery time needed. For the first evening and following morning I find people swell quite a bit, which resolves around 4 days post-procedure. By 2 weeks the fillers have typically settled, and the result is more accurate. The only real downtime is If bruising occurs and despite how amazing some injectors are, bruises are still a common occurrence.

Biodegradable: They gradually dissolve over time, usually lasting between 6 to 18 months depending on the brand and treatment area. Some people metabolize the fillers more quickly if they are on thyroid medicines or have extremely high metabolisms.

Hyaluronic Acid (HA) can be used for:

• fine lines and wrinkles around the mouth
• lip enhancement
• cheek volume and contouring to increase volume loss
• under-eye hollows — I prefer EZ Gel for this application, click here to learn more.

Side Effects
I think that everyone needs to go into their filler treatment, knowing the full risks of the procedure. Now… I don’t mean to scare you as all things have side effects (including that piece of chocolate or glass of wine you may have enjoyed last night). With hyaluronic acid, choosing a well-trained injector is very important for higher risk areas. Those areas include:

• around the nose and into the piriform space (nasolabial folds),
• the forehead,
• tear troughs (under eyes),
• 11 lines aka Glabella liquid rhinoplasty (directly into the nose and temples).

These rare complications are possible in other areas of the face including the lips. If filler is injected directly into the blood vessel supply, it can block blood flow to the area. This can cause swelling, redness and heat, pain, pustules and eventually if not treated (by dissolving with an enzyme), it can lead to tissue necrosis requiring surgical intervention.

Many safety techniques are used to minimize complications, but in the hands of an injector who doesn’t fully understand the complexity of facial anatomy, things can go wrong. Even with a highly skilled and experienced injector, complications can still rarely occur. Before undergoing treatment, make sure your injector discusses potential risks with you and is well-prepared to manage any complications—after all, your safety should be their top priority. All of this being said, hyaluronic acid (HA) fillers are generally safe, and these risks don't deter most people given they are rare outcomes.

What is Radiesse?

Radiesse is a unique type of filler that uses calcium hydroxylapatite (CaHA) microspheres suspended in a gel carrier. It not only adds immediate volume but also stimulates your body’s natural collagen production, offering longer-lasting results. It is one of the best biostimulants out there, and given we naturally have CaHA in our bones, the body has a very low reactivity to it.

When the cellulose base beings to dissolve, CaHA microspheres are released which provide structure and stimulate collagen production, which helps maintain volume even after the gel has been absorbed by the body. Giving it a longer-term effect to help maintain lift and tightness to your face.

When Radiesse is injected, it is very common to swell asymmetrically on the first day and most people do well if they take an antihistamine. Other than the swelling, it heals well, provides natural looking results and stimulates you back into a youthful glow. As with any injection, bruising is also possible.

Radiesse has some specific great benefits and my favourite place to use it is hyper diluted and into the hands, lower face and neck. When issuing it hyper dilute it requires a few treatments, but next to a face and neck lift, nothing compares.

Radiesse has long-lasting results because it has encouraged collagen production from the inside to improved skin texture and elasticity. Thus, return of lines and texture over time becomes subject to your aging such as: hydration, genetics, hormones/menopause, skin care, stress, and oxidation all play a role here.

Effects of Radiesse can last up to 12 to 18 months or longer in some cases. It is particularly effective for deeper lines and volume loss, especially in the mid and lower face, it provides immediate volumizing, providing instant results. Radiesse is semi-permanent when used undiluted as a filler, meaning that it cannot be dissolved if the patient doesn’t like the aesthetic result.

I choose Radiesse for patients when they metabolize filler very quickly and want collagen stimulation to fill in areas of lost fat in the mid lower cheek, when they want a drastic chiseled jaw, hand rejuvenation and longer lasting results.

Key Differences Between Hyaluronic Acid Fillers & Radiesse:

Feature	Hyaluronic Acid Fillers	Radiesse
Ingredient	Hyaluronic Acid	Calcium Hydroxylapatite
Longevity	6-18 Months	12-18 Months+
Reversibility	Yes (with Hyaluronidase)	Non-Reversible
Collagen Stimulation	Minimal	Significant
Texture	Soft, Gel-Like	Thicker, Firmer, Works Well Hyper Diluted
Treatment Areas	Lips, Cheeks, Under Eyes, Fine Lines	Lower Face, Jaw, Cheeks, Hands
Downtime	Minimal	Slightly Longer (Day 1 Swelling)
Ideal For	Fine Lines, Lips, Contouring	Deep Lines, Volume Loss, Jawline

Hyaluronic Acid vs. Radiesse: How Do I Choose?

It’s sometimes a difficult choice for the patient and often an experienced provider will help you choose what is best for your skin. Often, they are used in combination for full results. If you’re looking for subtle enhancements or have concerns about reversibility, hyaluronic acid fillers are a safer option. Radiesse, on the other hand, is better suited for those looking for longer-lasting, more pronounced results with added collagen stimulation.

For areas that require a softer, more flexible filler like the lips or under-eye hollows, hyaluronic acid is preferred. We do not use Radiesse in either of these areas. Radiesse’s thicker consistency makes it better for areas requiring more structure, like the jawline and deeper folds.

Both fillers offer long-lasting results in most patients, but Radiesse generally lasts longer due to its collagen-stimulating effects. However, HA fillers are reversible, allowing for adjustments. One of the biggest advantages of hyaluronic acid fillers is their reversibility with hyaluronidase. Radiesse is not reversible, so any dissatisfaction will require waiting until the filler naturally dissipates. Both treatments have minimal downtime, though Radiesse may involve slightly more swelling or bruising due to the deeper injection technique.

Both hyaluronic acid fillers and Radiesse have their unique advantages and can deliver excellent, natural-looking results when administered by an experienced professional. The best choice for you will depend on your specific needs, desired outcomes, and comfort level with the treatment process.

A consultation with a qualified aesthetic provider (click here to meet our team) will help you make an informed decision tailored to your goals. We offer 30-minute consultations at our office to help decide what is best for you. Bonus... the cost of consultation can be applied to your treatment on the day of. Our team looks forward to working with you on your journey to confidence and maintained wellness.