LAM FACIAL PLASTICS

Dr Lam,

in your lecture you say you use radiesse for restoring volume to cheeks. I know that filler is long term but not permanent. It's mineral particles suspended in gel that create a scaffold for the skin fibroblasts to create collagen.

I wonder after the created volume is absorbed in a few years what is left of the filler. Do the mineral particles remain in the skin and if yes why they don't stimulate the fibroblasts anymore?

That is a tough question since collagen and fibroblasts are difficult things to quantify. I don't think anyone really has an answer to your question. Part of the reason i use very little radiesse today is that i perform so much fat grafting. Since i don't know when the radiesse really is "gone", i find much more comfort in doing fat grafting over a dissolvable product like Perlane and Restylane.

Nevertheless, Radiesse I find to be still a fantastic product for cheek augmentation in someone not interested in fat grafting at all or for many years like you. Unfortunately, I don't have a good answer for you regarding what happens to the fibroblasts after a year or two. Suffice it to say that in most cases your aesthetic result is entirely gone within 8 months to 1.5 years in most cases.
best,
sml

I found on this site

http://www.consultingroom.com/Treatment ... %E2%84%A2-

a claim that the mineral particles are 'gradually broken down and completely metabolized by the body'. I'm not a biochemist but never heard that skin can 'break down' mineral particles in it.

Obviously, none of us has the answer. However, Radiesse can linger for even several years before being completely resorbed. Initially, studies that were presented showed radiographic (i.e., x-ray) longevity of 3 to 4 years meaning that even though the clinical effect is gone, there probably may be some particles left.

I can't answer your questions why "minerals" would be resorbed. But our body really clears most things. For example, why would we resorb collagen that is injected, or restylane, or any of those materials per se. Our macrophages can clear a lot of products in our system. Bottom line, I trust that Radiesse is a safe product that does linger for quite some time that clinically has a lifespan of 8 months to a year and a half or so. Hope that helps.

Best,
SML