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As more newly developed soft tissue fillers enter the market as a result of the ever increasing demand for cosmetic facial rejuvenation, it becomes even more important for consumers to understand their choices and use the services of experienced physicians who know which products work best for which procedures. Board-certified plastic surgeon, Dr. Scott W. Mosser, can't avoid having favorites based on the results obtained on his own patients. "Some fillers simply work better than others for specific procedures," says Dr. Mosser. "so a very important step in performing facial rejuvenation is choosing the right formulation for the right job." He was gratified recently to read the published results of an objective blind study comparison over a 12-month period of two distinct injectable materials: Calcium Hydroxyapatite (CaHA) (trade name RadiesseŽ) and (HA) Hyaluronic Acid (trade name RestylaneŽ). The results confirmed his own experience - that RadiesseŽ is more effective and lasts longer than RestylaneŽ when used for the correction of nasolabial folds. Dr. Mosser runs a busy plastic surgery practice in downtown San Francisco and is a leader in the use of injectables and dermal fillers to treat facial wrinkles both for cosmetic purposes to reduce signs of aging and for medical purposes for facial regeneration to correct wasting due to accident or illness. He spent his fellowship in California cosmetic surgery and has extensive expertise in dermal injection facial regeneration as well as other surgical cosmetic procedures for the elimination of facial wrinkles. The clinical trial, jointly carried out by physicians in two clinics, one in Munich, Germany, and one in Barcelona, Spain*, treated the nasiolabial fold of 60 patients (52 females and 8 males) and evaluated the results after 6, 9, and 12 months. Each subject received injections of RadiesseŽ in the nasiolabial fold on one side of the face and RestylaneŽ in the fold on the other side. The same 27-guage needles and injection techniques were used to inject into the mid to deep dermis on all subjects. The objective of the study was to assess the effectiveness and longevity of a CaHA (RadiesseŽ) filler versus an HA (RestylaneŽ) filler. Internationally accepted rating systems (the GAIS and WSRS) were used to evaluate the results as well as the opinions of blinded evaluators and the patients themselves. By all criteria the RadiesseŽ side outperformed the RestylaneŽ side. The CaHA filler demonstrated greater improvement and longer lasting results. They also found that 30% less total volume of the CaHA filler was required compared to the HA filler. In addition, blinded evaluators and patients both preferred the RadiesseŽ side two to one. Both products were found to be safe and well tolerated. RadiesseŽ costs more than RestylaneŽ (usually about $900 versus $600) but since less RadiesseŽ is used per injection and the injections are less frequent, the RadiesseŽ treatments will work out to be more economical in the long run. Dr Mosser made it clear that he never promotes one brand of filler over another, but matches the most effective treatment to each individual patient's requirements based on his expertise and experience. Another dermal filler, SculptraŽ, is especially popular in the San Francisco area and Dr. Mosser is a leader in its application to correct facial wasting that is often a side effect of treatment for HIV. He recommends that anyone interested in wrinkle therapy or cosmetic surgery should research the possibilities beforehand and use only the services of a Board-Certified Plastic Surgeon with proven experience and expertise in the procedure desired. *Moers-Carpi,MM,MD and Tufel, JO, MD. Calcium Hydroxylapatite versus Nonanimal Stabilized Hyaluronic Acid for the Correction of Nasiolabial Folds: A 12-Month, Multicenter, Perspective, Randomized, Controlled, Split Faced Trial, Dermatol Surg 2007;34:1-6.
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