Sculptra and Radiesse

Poly-L-lactic acid (Sculptra) and calcium hydroxylapatite (Radiesse)

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How it works

Sculptra’s effect builds over weeks

Subcutaneous tissueNeedle

Poly-L-lactic acid or calcium hydroxylapatiteSculptra’s effect appears over weeks; Radiesse’s gel is replaced by tissue

Layers, top to bottom: epidermis, dermis, subcutaneous tissue, muscle, bone.

Sculptra

weeks

At injection: a bolus of the suspension under the depressed area

Over several weeks, the depressed area improves gradually

Radiesse

later

At injection: the particles in a gel carrier, laid as a line

Later: the gel dissipated, soft tissue grown in its place, the particles still there

EpidermisDermisSubcutaneous tissueMuscleBoneNeedle

Poly-L-lactic acid or calcium hydroxylapatiteSculptra’s effect appears over weeks; Radiesse’s gel is replaced by tissue

Sculptra

weeks

At injection: a bolus of the suspension under the depressed area

Over several weeks, the depressed area improves gradually

Radiesse

later

At injection: the particles in a gel carrier, laid as a line

Later: the gel dissipated, soft tissue grown in its place, the particles still there

Deep dermis or subcutaneous layer, as small boluses or a line. Sculptra: “into the deep dermis or subcutaneous layer”, as boluses of about 0.05 mL, never into muscle; the effect “appears gradually over a few weeks”. Radiesse: “subdermal implantation”, laid as a line while the needle withdraws, and in the hand as boluses between the tendons; the gel carrier “is dissipated in vivo and replaced with soft tissue growth”. Illustrations are schematic.

What it costs

$900 to $1,200 a vial of Sculptra at five clinics, 2 vials a session in the study

AreaPer vial or syringe
Sculptra, per vial$900 – $1,2005 clinics
Radiesse, per 1.5 mL syringe$880 – $1,2004 clinics
Radiesse, per 1.5 mL syringe$880 – $1,2004 clinics

The study’s amount at the clinic price

$1,800 – $2,4002 vials at $900 – $1,200, before tax

16 mL a session, both cheeks, is the median in the maker’s cheek study, one vial a side at most, 3.6 sessions on average, 97 people; each vial 9 mL as that study mixed it. This estimate covers one session, not the course.

Nineteen clinic pages, three maker studies. Five pages price a Sculptra vial, $900 to $1,200; four price a Radiesse syringe, $880 to $1,200, one of them selling two syringes for both hands at $1,500. The rest quote on consultation or state a market range. Study amounts are each study’s own: the median a session in Sculptra’s cheek study, at 9 mL a vial as that study mixed it; Radiesse’s mean in a fold over up to three injections, and the median first treatment of a hand, lidocaine mixed in, at 1.76 mL a syringe once its lidocaine is added, rounded up to whole units. Canadian dollars before tax, as the clinic pages state them.

Results & duration

Fewer cheek wrinkles at one year

Different studies and endpoints; these figures do not rank products. The makers’ studies use different scales, controls and follow-up times. Sculptra’s cheek and fold studies are read from the FDA summaries; Radiesse’s fold and hand studies from Merz’s US directions. The Sculptra fold results keep their original score units and baseline-severity groups rather than inventing a share improved.

Doctor-rated wrinkles, both cheeks

Fewer cheek wrinkles at one year

71.6%Sculptra · 63 of 88 people

26.1%No treatment · 12 of 46 people

A grade or more on the maker’s scale in both cheeks, rated live by a blinded evaluator, of those seen at month 12. The untreated group was treated after.

FDA 2023, P030050/S039

How long it was measured

Still fewer at two years

76.9%50 of 65 people

Of those still followed at the last visit, none treated again; the end of the effect was not measured.

FDA 2023, P030050/S039

How long do Sculptra and Radiesse last?

Some participants remained improved at the last follow-up; the studies did not establish when the effect ends. In Sculptra’s cheek study, 76.9% of those still followed had fewer wrinkles at month 24, the last visit, with no further treatment; its fold study reported the effect maintained to 25 months; the Canadian directions state that safety and effectiveness beyond two years have not been studied. Radiesse’s directions call it “long-term yet non-permanent”: 68.2% of participants still followed a year after one treatment had hands still rated fuller, and the fold study measured six months. Health Canada puts dermal fillers generally at six months to a year or more.

FDA · Sculptra P030050/S039 and P030050/S002 · Sculptra directions · Radiesse directions · Merz US directions, face and hand · Health Canada · Cosmetic injections (2015)

Recovery & risks

Tenderness and bruising for most, mostly resolved within 14 days

Sculptra in the cheeks · 28-day diaries, 93 people

  • Tenderness93.5%
  • Bruising93.5%
  • Swelling87.1%
  • Pain83.9%
Most reactions
Mild or moderate for 97.8%; 76.1% resolved within 14 days. The Canadian directions put the usual reactions at 2 to 6 days; 90% in the study felt comfortable in company again by 7.1 hours.
Weeks later
Adverse events tied to the product or the injection in 20 of 97 people, bruising in 11 of them for a median 9 days; one had small nodules on both cheeks appear 180 days after the last session, still there at the study’s end; one had a small lump appear 9 days after, gone by day 327.
Massage and the next session
Five minutes, five times a day, for five days, the Canadian directions say, to spread the product; re-assessed no sooner than 4 weeks after a session. The study gave up to 4 sessions, 4 weeks apart.

Side effects reported to Health Canada

A nodule in 1% of 97 people after Sculptra in the cheeks, a small lump in 1%; in the fold study, a nodule or papule in 17.2% of 116. The Canadian directions report nodules appearing 3 to 6 weeks and 1 to 14 months after, some lasting up to 2 years. Product in a vessel: no rate established.

Lumps and nodules

Skin necrosis, from product in a vessel

Vision impairment or blindness

Reactions reported to Health Canada for dermal fillers, and both directions’ warnings on injection into a vessel · Illustrations are schematic.

Read from the studies and the directions for use. The diaries of each study and the adverse events counted past them. Downtime is not counted in any of them; the nearest measures are the shares whose reactions ran past 14 days and, for Sculptra, the hours until people felt comfortable in company. The harms on the cards are those reported to Health Canada for dermal fillers.

Frequently asked questions

Licensed as Class III medical devices. Health Canada lists Sculptra on Q-Med’s licence 71658, first issued in 2006, and Radiesse on two of Merz North America’s, 78893 for the injectable implant set, first issued in 2009, and 95140 for Radiesse (+), the syringe with lidocaine, first issued in 2015. A licence records Health Canada’s review of the device against its safety and effectiveness requirements for the use filed; it does not establish every benefit, area or duration a clinic advertises.Health Canada · MDALL licences 71658, 78893 and 95140

GST or HST applies to taxable cosmetic treatments: 13% in Ontario, 5% where only GST is charged. The clinic prices here are before tax. A treatment for a medical or reconstructive purpose may be exempt when it meets the applicable health-care exemption’s conditions, including who supplies or performs the service; its purpose alone does not establish an exemption.Excise Tax Act · s. 165, Sch. V Pt. II ss. 1, 1.1, 1.2 and 5 to 7, Sch. VIII

A physician, a nurse practitioner, or a nurse working under one. The College of Nurses of Ontario’s guideline on aesthetic services (2026) names administering a substance by injection among the controlled acts, so an RN or RPN needs an order or directive from a nurse practitioner or physician, while nurse practitioners are autonomous. Both products’ directions restrict them to health care practitioners with training and experience who know the anatomy at the site. Other provinces set their own rules.CNO · Aesthetic services, practice guideline (2026) · Sculptra and Radiesse directions

Not in the figures above. Every number is read from a study the maker ran for its US approval, as the FDA summarized it or as the maker reported it in its US directions. The raters were blind and each study had a comparison, an untreated group or a collagen implant in the other fold, but the maker chose the scale, ran the study and wrote it up. This page cites no trial run by anyone else.FDA · Sculptra P030050/S039 · Merz · Radiesse US directions, face and hand

No. Neither is hyaluronic acid, so hyaluronidase does nothing to them. Radiesse’s directions state it “can be easily added in subsequent injection, but cannot be easily removed”, and that a nodule may need treatment or removal. Sculptra’s directions state that nodules and late granulomas have resolved on their own or after repeated injections of corticosteroids or 5-fluorouracil, and that larger ones, or those in difficult places such as the lower eyelid, have sometimes needed surgical excision.Sculptra directions, adverse reactions · Radiesse directions, precautions

Several for Sculptra, usually one or two for Radiesse. Sculptra’s directions say a first session gives a limited correction, re-assessed no sooner than four weeks later, and that more than one session is typically needed; its cheek study averaged 3.6 sessions, up to four, four weeks apart, one vial a side. Radiesse is placed to a 1:1 correction in one visit, added to no sooner than seven days later, the directions say; the fold study allowed up to three injections over four weeks, and 69% in the hand study took a second treatment at six months.Sculptra directions · FDA · Sculptra P030050/S039 · Radiesse directions · Merz US directions, face and hand

Sources

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