Sculptra vs Radiesse vs hyaluronic acid filler

The short answer

Three different ideas of "filler." Hyaluronic acid (HA) fillers such as Juvederm, Restylane and Voluma are a gel that occupies space: what you see at the end of the visit is roughly what you get. Radiesse is calcium hydroxylapatite in a gel; it fills immediately and then stimulates collagen as the gel breaks down. Sculptra is poly-L-lactic acid; it does very little on the day and works by making your skin build its own collagen over two to three months. Alina McCann, NP, uses all three and picks by what the face needs and how patient you are.

At a glance

Hyaluronic acid: precise, reversible, immediate

HA filler is the right choice when the job is shape: a defined lip, a sharper chin, a hollow under the eye. It is also the only one that can be undone, with an enzyme, which makes it the safe first filler. The trade-off is duration. Soft products in mobile areas last six to nine months; firm products such as Volux in the jawline last up to 18. Our HA fillers are listed on the fillers we use page.

Radiesse: volume now plus collagen

Radiesse gives a firm, immediate lift and leaves collagen behind as it clears, so patients often need less at the next visit. It suits the jawline, cheeks, and especially the backs of the hands, where it is the only FDA-approved filler. It is not used in the lips or under the eyes, where its firmness and the risk of visible lumps are a problem, and it cannot be dissolved.

Sculptra: the slow build

Sculptra is for the face that has lost volume everywhere, the "deflated" look of the mid-forties onward, rather than one feature. Alina injects it across the cheeks, temples and jawline in two or three sessions; the collagen that follows is yours, distributed naturally, and lasts around two years. You will not see much for the first month, which frustrates some patients, and like Radiesse it cannot be reversed. We do not use it in the lips or under the eyes. Read more on the Sculptra page.

Cost over two years

A patient who needs two syringes of HA every nine months spends about $2,900 over two years at our prices. Two vials of Sculptra in two sessions, about $2,800, covers roughly the same period across a wider area. Radiesse sits between. The products are closer in long-run cost than the per-syringe numbers suggest; what differs is when you see the result and whether you can undo it.

Who should choose which

HA filler for first-time filler patients, lips, under-eyes, chin, and anyone who wants to see the result before committing to more.

Radiesse for hands, jawline and cheeks in patients who want an immediate result that also improves skin quality, and who have had filler before.

Sculptra for diffuse volume loss, patients who prefer a gradual, natural change nobody can point to, and those who want the longest interval between visits. Often combined with a little HA where Sculptra does not go.

Prices for all three are on the price list.