Today we would like to talk about a question that practitioners have about the possible combination or contradiction of drugs from the Belotero® group; and preparations Radiesse ("Radies"). Are they allies or adversaries? Friends or enemies? What can we say exactly here, based on clinical experience? Tatyana Pavlenko, Ph.D., dermatologist, cosmetologist, Merz Aesthetics certified trainer in injection techniques, shared her point of view on the use of these drugs, based on her own practice, with readers of estet-portal.com.
Combinations of "Radies" and "Belotero" preparations depending on the type of skin aging
Definitely, these two drugs "Belotero" and "Radies" from Merz Aesthetics have huge advantages, and often this does not contradict their interaction with each other. Most often we use them in a great combination. Let's take a look at the points.
Firstly, if we are talking about volumetric properties of, for example, Radiesse and Belotero Volume, when can we give preference to one or the other? We all remember the classification of different types of aging according to Kolgunenko from 1978. And if we are talking about Radiesse as a volumizer, this is a unique, the only volumizer that will not give increased puffiness in patients with edematous, or pasty, or tired type of aging. Where the use of any hyaluronic acid is associated with a high risk of developing post-procedure swelling, Radiesse absolutely insures us against this, and we get a high-quality clinical result, guaranteeing our patients that we will not aggravate the features that the patient complained to us about during the visit.
Let's consider volume correction in other types of aging. For the deformation type, whether to choose the drug "Radies" or hyaluronic acid is a decision in the hands of the doctor. For this type of aging, I also use Radiesse in my practice. Why? Because even though he is a great volumizer, he has another very good quality.
Radiesse has a special property the possibility of stimulating the production of physiological collagen.
And, accordingly, choosing it as a volumetric filler, but also working in the projection of the ligaments, I get a double result. This is the replenishment of areas that need additional volume, and excellent stimulation of the ligamentous apparatus. 2-3 months after the procedure, this will lead to an additional effect excellent lifting effect. Accordingly, the combination of the properties of a volumizer and a stimulator in patients with a deformation type is absolutely justified.
Let's consider a finely wrinkled type of aging. In those patients who, with age, tend to degrade and some destruction, initially in a small amount of subcutaneous adipose tissue present, here my choice is definitely "Belotero". And for volume correction, I prefer Belotero Volume. Why? Because here we need that loose volume, perhaps even a slight suprathreshold puffiness, which will look very adequate on these faces with a deficiency of subcutaneous fatty tissue, with a tendency to skeletonization. And thanks to hyaluronic acid preparations, this is where we can get a more pronounced, better and longer clinical result.
Muscular type of aging. With this type of aging, we can use both "Radies" and preparations of the "Belotero" line for volumetric modeling. Why? Because we do not have a pronounced puffiness. Everything will depend on the volume deficit that the patient indicates to us and which we ourselves will see during the examination. If the volume deficit is pronounced, if these are some features of the anatomy, architectonics of the face, in my practice I use Belotero Volume as a drug that can give a more pronounced volume.
Rarely can we classify our patient as an isolated type of aging, finely wrinkled, deformed, edematous or muscular. Most often we are talking about a combination of types.
In patients with a muscular type of aging, but with some tendency to swelling, of course, a clear choice this is Radies. And even the use of Belotero Volum and other drugs of the line in any case does not cancel the simultaneous administration of Radiesse as a stimulant.
For example, we can talk about the same patients with a finely wrinkled, muscular type of aging, about the need for volumization with the help of the Belotero Volum hyaluronic acid preparation, with the implementation, for example, of simultaneous vector lifting procedures, with the work with the Radies preparation in dilution to stimulate the improvement of skin quality.
Thus, the methods of using the preparations "Radies" and "Belotero" are absolutely composable, they are combined with each other with high efficiency.
Using a combination of Radiesse and Belotero to improve skin quality.
If we are talking about the quality of the skin of our patients, then the main criterion for choosing a drug to improve the quality of the skin is the age of the patient. If, for example, a young patient comes to us for an appointment, with good skin quality, but with initial static changes, with delayed botulinum therapy, with static between the eyebrows, with static forehead wrinkles, with wrinkles in the periorbital zone, changes in the skin of the neck, my recommendation is - these are Belotero preparations in the "Blanching" technique: "Belotero Soft", "Belotero Balance". The choice depends directly on the thickness of the patient's skin and on the intended injection site.
My recommendation is Belotero preparations in the "Blanching" technique: "Belotero Soft", "Belotero Balance". The choice depends directly on the thickness of the patient's skin and on the intended injection site.
When we still see a trend towards involutive skin changes and we are talking about patients in the 35+ age group, for me this age is a certain barrier, after which I can consider the active use, perhaps a course, of the drug "Radies" specifically for stimulation and specifically to replenish the pool of young collagen fibers. In this case, definitely my choice is the drug "Radies". Perhaps it will be diluted, perhaps in an undiluted state of aggregation, only with the addition of lidocaine, we will use it in the technique of vector lifting, radial lifting. But again, this in no way cancels the possibility of simultaneously conducting the "Blanching" technique.
We know that, for example, in the perioral zone, in the periorbital zone, in the forehead and between the eyebrows, we do not recommend the use of Radiesse. Accordingly, for patients who already have initial or pronounced age-related changes, our choice is a combined technique: the use of Radiesse for stimulation and work with static using the Blanching technique with the Belotero line of preparations. For Blanching, I remind you, we use only two preparations: these are Belotero Soft and Belotero Balance.
And the third age group of our patients is over 60 years old. Perhaps this is not a very large group at cosmetology appointments, but nevertheless, there are also such patients. For them, in my practice, I intensively use the Belotero line. Why? I'm not sure about Radiesse at this point, but about this patient's own skin stimulation reserves. If menopause occurred 10-15 years ago, and the patient did not receive hormone replacement therapy (unfortunately, the main pool of our patients does not receive it), then it is at least imprudent to count on high-quality collagen synthesis. Here, too, I give priority to Belotero preparations using the Blanching technique.
And this clinical division of my patients into groups for the use of, for example, the "Blanching" technique with Belotero by Merz Aesthetics in very young patients, for the combination of surface injection techniques at the level of the papillary dermis in patients of the middle age group together with the techniques of the stimulating effect of the drug "Radies" (calcium hydroxyapatite preparation) and, again, replenishment techniques, deficiency replacement techniques, smoothing techniques in patients of the older age group always give very positive results and replenish my treasury of grateful patients.
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