TORONTO The injectable filler Radiesse appears to offer an edge over Sculptra when it comes to ease of use, cost-effectiveness, and patient satisfaction, Dr. Stuart Bentkover said at the annual fall meeting of the American Academy of Facial and Reconstructive Plastic Surgery.
Dr. Bentkover offered results on 216 patients using both products at his facial plastic surgery practice in Worcester, Mass.
Radiesse "is, out of the box, very easy to use on day 1," he said. There is an immediate augmentation with the product, but about 10% will be lost by 26 months. He tells patients that the full effect lasts about 1014 months.
The product, composed of calcium hydroxylapatite microspheres and sold by BioForm Medical Inc., is approved by the Food and Drug Administration for oral and maxillofacial defects, vocal fold insufficiency, and radiographic tissue marking. Approval is pending for HIV-related lipoatrophy and nasolabial folds (SKIN & ALLERGY NEWS, October 2006, p. 1).
Sculptra (injectable poly-L-lactic acid) is approved by the FDA for facial fat loss in HIV-infected patients and is used off-label for cosmetic purposes. It is not as patient- or user-friendly because patients must massage the area five times daily for 5 minutes for 5 days after injection, he said.
Sculptra is sold by Dermik Laboratories, a subsidiary of Sanofi-Aventis.
Unlike Radiesse, which can be used quickly, Sculptra has to be reconstituted 2 hours before the procedure. The product does not stay in suspension easily and often requires multiple syringes, as they tend to clog, Dr. Bentkover said.
He calculated the surgeon cost per session at $304 with Radiesse, compared with $480 for Sculptra. The costs are not radically different, but the need for a second session is higher with Sculptra, he said.
With Radiesse, he has seen persistent erythema in two patients, a viral infection, and skin slough. The most common complication is superficial injection. Four patients who received Sculptra injections developed nodules, mostly around their eyes.
Overall complication rates in his experience were 4.6% for Radiesse and 19% for Sculptra. These are, however, based on a small number of patients, he said.
Dr. Bentkover said that he has stopped using Sculptra because of the complication rate.
Another surgeon, Dr. Phillip Langsdon, chief of facial plastic surgery at the University of Tennessee in Memphis, said that he thinks Sculptra is a good product with few side effects. "I've been injecting Sculptra for 2 years and haven't seen any nodules yet," he told meeting attendees.
Dr. Langsdon said that he had no interest in Dermik or Sanofi-Aventis.
Dr. Bentkover is on the national teaching faculty for Radiesse and lectures for Rhytec Inc.