Radiesse in NYC is one of the injectables I use when the face, the jawline or the backs of the hands need structure and support. It adds volume right away, and it also prompts your skin to build collagen around it over time [5].

What Radiesse is

Radiesse is an injectable made of calcium hydroxylapatite (CaHA) microspheres in a water-based gel. CaHA is a man-made form of a mineral found naturally in bone and teeth [1]. Radiesse is not animal-based, and allergy pre-testing isn't required [1]. Radiesse (+) also contains lidocaine, a local anesthetic; in a clinical study, it reduced pain during and after injection [1].

The FDA approved Radiesse in 2006 for moderate to severe facial wrinkles and folds, such as the lines from the nose to the corners of the mouth (nasolabial folds), and for restoring facial fat loss in people with HIV [2]. In 2015, it was approved to restore volume in the backs of the hands [3], and in 2021, Radiesse (+) was approved to improve moderate to severe loss of jawline contour in adults over 21 [4].

Immediate volume, plus collagen over time

Radiesse works in two ways. The microspheres add volume and lift as soon as they are placed. Over time, your body forms collagen around them [5][6]. That is why Radiesse is often grouped with Sculptra as a "biostimulator," even though it also fills in the way a traditional filler does.

You can read more about my approach to fillers, including Radiesse, on my practice site.

I've been noted as a master injector by Allergan, Galderma and Merz [5].

Disclosure: Merz Aesthetics makes Radiesse [1].

The hyperdilute technique

Radiesse can also be mixed with more liquid (diluted or "hyperdiluted") and spread in a thin layer under the skin. Used this way, the goal isn't volume. It's to stimulate collagen to improve skin laxity and skin quality [7]. A global expert consensus describes this use in the mid and lower face, neck, décolletage, upper arms, abdomen, upper legs and buttocks [7], and a 2024 systematic review covers its use on the neck, arms, thighs, abdomen and other body areas [10].

I use Radiesse on the body too, most often on the upper arms, the neck and the skin above the knees, usually with the hyperdilute technique. Small studies have looked at hyperdilute Radiesse in each of these areas: the neck [11], the upper arms [12] and the skin above the knees [13].

This is off-label use. Radiesse's FDA approvals cover the face, the backs of the hands and the jawline [2][3][4]. The consensus authors describe their guidance as preliminary [7], and the 2024 review notes that body use has yet to be supported by randomized controlled trials [10].

Typical treatment areas

• Facial wrinkles and folds, such as nasolabial folds [1][2]
• The jawline, to improve contour (Radiesse (+), adults over 21) [4]
• The backs of the hands, to restore volume so veins and tendons are less visible [3]
• The upper arms, the neck and the skin above the knees, usually with hyperdilute Radiesse (off-label) [10][11][12][13]
• Other face and body skin laxity, using diluted or hyperdiluted Radiesse (off-label) [7]

Off-label means the FDA hasn't approved Radiesse for that area. Its approvals cover the face, the backs of the hands and the jawline [2][3][4].

The safety and effectiveness of Radiesse (+) in the lips and around the eyes have not been established [1].

Radiesse or Sculptra?

Both stimulate collagen, but they work on different timelines:

• Radiesse (calcium hydroxylapatite) gives visible volume right away and builds collagen over time [5][6].
• Sculptra (poly-L-lactic acid) doesn't fill space directly. It works gradually over several months as your skin builds collagen.

In a 2026 systematic review of facial studies, effects lasted up to 25 months with poly-L-lactic acid and 12 to 18 months with calcium hydroxylapatite [8]. Those are study results, not a promise. Which one fits depends on the area, your skin and your goals, and I'll go through the options with you.

How I combine it

Radiesse is often one part of a plan rather than the whole plan. Depending on your skin and goals, I may combine it with Sofwave, an in-office treatment that uses ultrasound energy to heat the mid-dermis [15]. For the body, I may also add home care with my Retinol Body Serum, which is made for the neck, arms, chest, knees and legs and is designed for crepey, dry and sun-damaged skin [16]. I'll plan the order and timing of each step with you.

What treatment looks like

Each visit starts with your goals, your medical history and the areas we agreed on. Radiesse (+) contains lidocaine, and the skin can also be numbed with a topical or injected anesthetic [1]. I place small amounts with a thin needle and may gently massage the area so the product spreads evenly [1].

The number of sessions depends on your face and your plan. A touch-up is sometimes needed, usually about 2 weeks to 1 month after the first treatment [1].

Afterward, limit sun and heat on the treated area for 24 hours, or until early swelling and redness settle [1]. You may feel the product as firmness under the skin; this goes away over several weeks [1].

In the FDA jawline study, 75.6% of treated patients showed improvement in jawline contour 12 weeks after treatment [1]. Those are study results, not a promise.

Risks and side effects

In the clinical studies, most side effects were mild. The most common were swelling, redness, pain, bruising and itching [1]. In the jawline study, most side effects lasted 7 days or less, though some lasted 2 to 4 weeks [1]. Small lumps (nodules) can form [1]. On the body, side effects reported in a small study above the knees included swelling, redness, bruising and skin irregularities lasting 2 to 3 weeks [13], and non-inflammatory nodules have been reported after hyperdilute treatment of the neck [14]. As with any filler, an accidental injection into a blood vessel is rare but serious and can cause skin damage, vision problems or stroke [1].

Radiesse (+) should not be used if you have severe allergies, a bleeding disorder, or an allergy to its ingredients or to lidocaine [1]. Its safety in pregnancy and breastfeeding hasn't been established [1]. The microspheres can show up on CT scans and X-rays, so tell your doctors and radiologists that you've had Radiesse [1]. Removing filler can be difficult or impossible, and removal procedures carry their own risks [9].

Frequently asked questions

Radiesse vs Sculptra?

Radiesse (calcium hydroxylapatite) adds volume right away and builds collagen over time. Sculptra (poly-L-lactic acid) works gradually over several months as your skin builds collagen [5][6]. Which one fits depends on the area and your goals.

Is Radiesse FDA-approved?

Yes. Radiesse is FDA-approved for moderate to severe facial wrinkles and folds, facial fat loss in people with HIV and volume loss in the backs of the hands. Radiesse (+) is also approved for moderate to severe loss of jawline contour in adults over 21 [2][3][4].

What is hyperdilute Radiesse?

It's Radiesse mixed with more liquid and spread thinly under the skin to stimulate collagen for skin laxity, rather than to add volume. It's an off-label use, and expert guidance on it is still described as preliminary [7].

Do you use Radiesse on the body?

Yes. I use it on the upper arms, the neck and the skin above the knees, usually with the hyperdilute technique. This is off-label: Radiesse's FDA approvals cover the face, the backs of the hands and the jawline. Small studies have looked at these uses, but they haven't yet been tested in randomized controlled trials [2][3][4][10].

Does Radiesse hurt?

Radiesse (+) contains lidocaine, which reduced injection pain in a clinical study. The skin can also be numbed before treatment [1].

Can Radiesse be removed?

Removing filler can be difficult or impossible, and removal procedures carry their own risks [9]. That's one reason careful planning matters.

What are the risks of Radiesse?

The most common side effects are swelling, redness, pain, bruising and itching. Nodules can form, and an accidental injection into a blood vessel is rare but serious [1].

About the author

Doris Day, MD, FAAD is a board-certified dermatologist and Clinical Professor of Dermatology at NYU Grossman School of Medicine. Newsweek, with Statista, consistently named her #3 on America's Best Cosmetic Dermatologists. She serves on the American Academy of Dermatology Nominating Committee (2025–present) and she advises major skin care and aesthetic companies on products and devices.

Medically reviewed by Doris Day, MD, FAAD on October 10, 2026. Last updated October 10, 2026.

Day Dermatology & Aesthetics 10 East 70th Street, Suite 1C, New York, NY 10021 (212) 772-0740

Sources

1. U.S. FDA. RADIESSE (+) Lidocaine Patient Information Guide, P050052/S129. https://www.accessdata.fda.gov/cdrh_docs/pdf5/P050052S129C.pdf
2. U.S. FDA. Premarket approval: RADIESSE, P050052 and P050037 (December 22, 2006). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P050052 and https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P050037
3. U.S. FDA. RADIESSE for the hands, P050052/S049 (June 4, 2015). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P050052S049
4. U.S. FDA. Summary of Safety and Effectiveness Data, RADIESSE (+) for jawline contour, P050052/S129 (September 1, 2021). https://www.accessdata.fda.gov/cdrh_docs/pdf5/P050052S129B.pdf
5. Day Dermatology & Aesthetics. Fillers. https://drdorisday.com/pages/fillers
6. Haddad S, et al. Evaluation of the biostimulatory effects and the level of neocollagenesis of dermal fillers: a review. Int J Dermatol. 2022;61(10):1284-1288. https://doi.org/10.1111/ijd.16229
7. Goldie K, et al. Global consensus guidelines for the injection of diluted and hyperdiluted calcium hydroxylapatite for skin tightening. Dermatol Surg. 2018;44(Suppl 1):S32-S41. https://doi.org/10.1097/DSS.0000000000001685
8. Ferreira ACM, et al. Efficacy, durability, and safety of collagen biostimulators based on poly-L-lactic acid (PLLA) and calcium hydroxyapatite (CaHA) in the face: a systematic review. Aesthetic Plast Surg. 2026;50(3):1291-1300. https://doi.org/10.1007/s00266-025-05412-8
9. U.S. FDA. Dermal fillers (soft tissue fillers). https://www.fda.gov/medical-devices/aesthetic-cosmetic-devices/dermal-fillers-soft-tissue-fillers
10. Galadari H, Guida S. A systematic review of Radiesse (calcium hydroxylapatite): evidence and recommendations for the body. Int J Dermatol. 2024;63(7):881-889. https://doi.org/10.1111/ijd.17085
11. Guida S, et al. Hyperdiluted calcium hydroxylapatite for the treatment of skin laxity of the neck. Dermatol Ther. 2021;34(5):e15090. https://doi.org/10.1111/dth.15090
12. Palo JS, et al. Improved brachial skin hydration and appearance with hyperdiluted calcium hydroxylapatite. Skin Res Technol. 2024;30(7):e13835. https://doi.org/10.1111/srt.13835
13. Guida S, et al. Hyperdiluted calcium hydroxylapatite for skin laxity and cellulite of the skin above the knee: a pilot study. Dermatol Ther. 2020;33(6):e14076. https://doi.org/10.1111/dth.14076
14. Nipshagen MD, et al. Non-inflammatory nodule formation after hyperdiluted calcium hydroxyapatite treatment in the neck area. Dermatol Ther. 2020;33(6):e14272. https://doi.org/10.1111/dth.14272
15. Day Dermatology & Aesthetics. Sofwave. https://drdorisday.com/products/sofwave
16. Doris Day MD. Retinol Body Serum. https://dorisdaymd.com/products/retinol-body-serum