Although there are a number of commercially-available injectable fillers for cosmetic facial treatments, they break down into two main categories or families, hyaluronic acids (hyalurons) and the particulated fillers. Particulated injectable fillers contain non-biodegradable beads or particles which accounts for their longer duration of persistence which is at least twice as long as most of the hyalurons. While the bead composition of each particulated filler only consists of about 20% of each syringe (any larger amount and the beads would not flow through a small needle) and the rest is the carrier vehicle, enough permanent material is placed with each injection session that a good duration of effect is achieved. In theory, with subsequent injection sessions, a greater degree of permanency is achieved each time as the bead layers are built up over time.
Amongst the particulated fillers there are only two types that are currently available, Radiesse vs. ArteFill. While there are differences in the makeup of the beads between the two, Radiesse with ceramic beads and ArteFill with plastic beads, the greater difference is in the type of carrier vehicle which makes up about 80% of the initial injected material. Radiesse uses a polyethylene glycol mixture while ArteFill uses bovine (cow) collagen. Because ArteFill uses an animal collagen, it requires a pre-injection skin test to rule out a sensitivity to it. Radiesse requires no such skin test.
One of the most interesting questions about the particulated injectable fillers is which one is better? Or from a patient’s perspective of better, ,which one lasts longer and would therefore be best? Radiesse reports persistence of the material for up to two years based on animal (rat) studies. Having used Radiesse a lot over the past 5 years, my human experience would not support that time duration. My experience of using Radiesse in the nasolabial (lip-cheek) folds is around 8 – 9 months on average. ArteFill has clinical studies which show persistence in some patients for years but I have not used it long enough to verify these findings in my practice. ArteFill uses a different injection approach by doing a series of treatments over a several month period to build-up multiple layers of the beads, thus creating greater permanency.
The bottom line question is….which is better…. Radiesse or ArteFill? Quite frankly, at this point in time, I do not know. Both work well.
Dr. Barry Eppley
Indianapolis, Indiana