Calcium Hydroxylapatite vs. Hyaluronic Acid Fillers for Wrinkles

The number of available filler materials is proliferating. In this multicenter, randomized comparison trial from Europe funded by the maker of Radiesse (calcium hydroxylapatite), 205 patients received Radiesse or one of three hyaluronic acid (HA) fillers for nasolabial fold correction. Juvederm 24 (not available in the U.S.), Juvederm Ultra, and Perlane were the HA filler alternatives. Mean total injection volumes were 2.2 mL of Radiesse, 4.8 mL of Juvederm 24, 2.9 mL of Juvederm Ultra, and 2.9 mL of Perlane. Patients received a touch-up treatment at 4 months and were followed thereafter for 12 months. Blinded evaluators assessed improvement in the nasolabial fold using the Global Aesthetic Improvement Scale (GAIS) and the Wrinkle Severity Rating Scale (WRSS).

Improvement at 4 months and at 12 months on GAIS assessment went from 96% to 62% in the Radiesse group, from 2% to none in the Juvederm 24 group, from 71% to 50% in the Juvederm Ultra group, and from 72% to 48% in the Perlane group. No statistically significant differences between fillers were seen on assessment with the WRSS. At 12 months, patient responses to questions about their happiness with results indicated that 77% to 95% of Radiesse recipients were satisfied, compared with 6% to 10% of Juvederm 24 recipients, 35% to 74% of Juvederm Ultra recipients, and 64% to 82% of Perlane recipients. No significant adverse events were noted with any of the filler materials.