With their safety, effectiveness, and longevity increasing, public interest in soft tissue fillers is proportionally increasing. Patients not yet ready for traditional cosmetic surgery are looking for simpler means to correct the gravitational and deleterious effects of aging. Be it the atrophy of facial fat, the thinning of lips, the furrowing of the middle and lower face, or the deepening of the melolabial (nasolabial) folds, soft tissue fillers offer an immediate and relatively uncomplicated corrective measure. Calcium hydroxylapatite (Radiesse, Bioform Inc.) is a recent entry into the cosmetic surgery practitioner's armamentarium.

CaHA is a biocompatible material that has the important qualities of being latex-free, nontoxic, nonmutagenic, nonantigenic, and nonirritating. It is a semisolid, cohesive implant material consisting of CaHA microspheres that range from 25 to 45 μm in diameter, suspended in a gel consisting of water, glycerin, and carboxymethylcellulose. CaHA is an inorganic component normally found in teeth and bone, thus its attractive safety profile. CaHA, which should be injected in a subdermal plane, has been shown to elicit no foreign body reaction or toxicity.

Although it has been used safely, and with Food and Drug Administration (FDA) approval, in laryngeal augmentation; soft tissue marking; and oral, maxillofacial, and dental defects for many years, it was not until January 2007, after extensive off-label use and study, that it was FDA approved for cosmetic facial soft tissue augmentation.

As with all procedures, the patient should be counseled regarding the risks of CaHA injection, specifically bleeding, ecchymoses, and edema.