Radiesse® is a calcium hydroxylapatite (CaHA) dermal filler widely used in aesthetic medicine for volume restoration and collagen stimulation. It has gained a strong reputation among medical professionals for enhancing facial contour and achieving long-term tissue improvement. The lower face—comprising the jawline, chin, and nasolabial folds—is especially relevant for structural support, age-related volume loss, and lower third facial harmony.
This guide is intended for licensed aesthetic practitioners and outlines evidence-based, anatomy-informed techniques for Radiesse lower face injection, including volume planning, injection depths, treatment protocols, and safety considerations. Accurate planning and repetition of Radiesse lower face injection techniques enhance patient outcomes, minimize complications, and support long-term aesthetic goals. Mastering Radiesse lower face injection protocols empowers clinicians to deliver natural-looking results in facial contouring procedures.
Radiesse® Properties
- Composition: Synthetic CaHA microspheres (25–45 µm) in aqueous gel
- Mechanism of action: Immediate volumizing + long-term neocollagenesis (Types I & III)
- Biocompatibility: Non-animal origin, biodegradable, non-immunogenic
- Duration: 12–18 months average, varies by metabolism and injection plane
| Property | Details |
|---|---|
| Filler Type | Biostimulatory, non-hyaluronic |
| Clinical Effect | Structural volume + collagen stimulation |
| Density & Elasticity | High G’ and cohesivity |
| Visibility in Imaging | Radiopaque (can be seen on CT, MRI) |
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Anatomical Considerations for the Lower Face
Proper understanding of facial layers, danger zones, and patient-specific anatomy is crucial when injecting CaHA-based fillers.
| Area | Key Structures | Injection Plane | Caution Points |
| Jawline | Mandibular ligament, facial artery | Supraperiosteal | Avoid marginal mandibular nerve |
| Chin | Mental foramen, depressor anguli oris | Deep subcutaneous / periosteal | Respect midline |
| Nasolabial folds | Angular artery, facial vein | Deep subcutaneous | Avoid intravascular injection |
Clinical Tip: Use ultrasound when uncertain about vascular pathways or for high-risk areas.
Indications for Lower Face Radiesse® Treatment
- Jawline contouring in aging or genetically weak mandibular definition
- Mild-to-moderate chin retrusion
- Restoration of deep nasolabial folds
- Post-weight loss facial volume loss
- Male facial enhancement (strong jaw aesthetics)
Injection Materials Checklist
| Required Item | Purpose |
| Radiesse® syringe (1.5 mL) | Biostimulatory filler |
| 25G x 50 mm cannula | Safer delivery and reduced trauma |
| 27G needle | Entry point and superficial deposits |
| Caliper or dermographic pen | Accurate marking |
| Antiseptic wipes & sterile gloves | Hygiene control |
| Cold pack or vibration tool | Patient comfort |
Techniques by Facial Subregion
1. Jawline Contouring
- Plane: Supraperiosteal or deep subcutaneous
- Cannula: 25G preferred
- Technique: Linear retrograde threading along mandibular angle and body
- Volume per side: 0.3 – 0.5 mL
| Parameter | Recommendation |
| Needle or Cannula | Cannula preferred for even spread |
| Entry point | Preauricular zone |
| Goal | Angular definition, lower face lifting |
2. Chin Augmentation
- Plane: Supraperiosteal bolus (central projection)
- Volume: 0.5 – 1 mL depending on depth and gender goals
- Technique: Single bolus or microboluses for shaping
| Feature | Clinical Note |
| Ideal patient | Class II profile, weak chin |
| Entry point | Submental or paramedian |
| Tool | 27G needle or 25G cannula |
3. Nasolabial Fold Softening
- Plane: Deep subcutaneous or pre-SMAS
- Tool: Cannula or sharp needle (if superficial)
- Volume per side: 0.3 – 0.6 mL
- Technique: Fanning or linear threading
Optional Dilution (Hyperdiluted Radiesse)
For patients requiring skin quality improvement over volumizing:
| Dilution Ratio | Indication |
| 1:1 (with saline/lidocaine) | Mild skin laxity, crepey skin |
| 1:2 or 1:3 | Biostimulation without volume |
Protocol: Reconstitute immediately before use; use 18G transfer needle for thorough mixing.
Post-Treatment Protocol
- Massage only if needed: Minor smoothing; excessive massage not recommended
- Avoid intense exercise for 24 hours
- No facials or manipulation for 48 hours
- Monitor for vascular signs: pallor, pain, skin discoloration
Safety Considerations
- Do not inject in lips, eyelids, or dynamic superficial areas
- Avoid use in autoimmune disorders or under immunosuppression
- Always aspirate when using needles in high-risk zones
- Use minimal effective volume and respect anatomical boundaries
Clinical Outcomes & Follow-Up
| Time Point | Expected Clinical Outcome |
| Immediate | Volume enhancement (due to gel) |
| 4–6 weeks | Onset of collagen synthesis |
| 3–4 months | Peak aesthetic effect |
| 12–18 months | Average duration (can vary individually) |
Follow-Up Tip: Consider a top-up session at 12 months for optimal maintenance.
Comparison: Radiesse® vs. Other Fillers in the Lower Face
| Filler | Composition | Duration | Plane | Key Benefit |
| Radiesse® | Calcium hydroxylapatite | 12–18 months | Deep/Supraperiosteal | Volume + Collagen stimulation |
| Juvederm® | Hyaluronic acid | 9–12 months | Mid-dermis | Hydration, soft tissue filling |
| Ellansé™ | Polycaprolactone | 24–36 months | Deep dermis | Structural longevity |
Conclusion
Radiesse lower face injection offers professionals a powerful tool for redefining facial harmony, especially in the chin and jawline. Its dual action—volumizing and biostimulatory—makes it unique among dermal fillers. Mastering safe injection depths, patient selection, and post-care leads to excellent long-term outcomes with low complication rates. Its high G’ makes it ideal for structural enhancement when used judiciously.
References (Official Sources)
- Merz Aesthetics. Radiesse® Prescribing Information. https://www.radiesse.com
- Kadouch J. “Calcium hydroxylapatite: a review on safety and efficacy.” J Cosmet Dermatol. 2017. https://doi.org/10.1111/jocd.12371
- Carruthers J et al. “Consensus Recommendations for CaHA Use in Facial Aesthetics.” Dermatol Surg. 2020.
- US FDA – Medical Device Approval. Radiesse Implant https://www.accessdata.fda.gov
- Merz Global Training Materials. Radiesse Clinical Protocols for Healthcare Professionals (internal documentation)