Dermal Fillers: Sculptra vs Radiesse

What Are Dermal Fillers?

Dermal fillers have become one of the ultimate cosmetic solutions for anti-aging without going under the knife. Some fillers produce instant results, while others take time to stimulate the body’s natural collagen production. Sculptra and Radiesse fall into the latter.

Both products initially came to market as a treatment for HIV patients to reclaim lost volume in their face due to lipoatrophy. With such great results in the HIV population, these products were then introduced into the aesthetics industry for age-related volume loss.


Radiesse is a thick injectable filler whose main component is synthetic calcium hydroxylapatite, a mineral with the same chemical composition as the material found in bones and teeth. The injected calcium hydroxylapatite particles function as a scaffold for new tissue growth. Radiesse instantly volumizes the treatment area because the injectable consists of calcium microspheres that provide an immediate support structure beneath the skin. They dissolve after several months, just as the newly formed collagen and tissue appear, resulting in a smoother, rejuvenated look. Radiesse results typically last about one year, with some patients enjoying younger-looking skin for much longer.

Before & After

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Gallery, AdvaTx, Hyperdilute Radiesse dermal fillers, Intracel, Ultherapy, Neurotoxins, chemical peels, IPL, Genesis, microneedling


Sculptra is made from poly-L-lactic acid (PLLA), a synthetic material that triggers the body’s inflammatory response and stimulates increased collagen production. It provides delayed but longer-lasting results. Sculptra provides gradual results because the PLLA particles act as a foreign body that stimulates increased collagen production. The effects become apparent after several weeks, with the skin’s tone and texture gradually improving in the following months. Sculptra provides the longest-lasting results of all dermal fillers – up to 24 months.

Before & After

sculptra logo
gallery, sculptra dermal fillers

In conclusion, both products are a phenomenal choice for volume restoration. Radiesse can provide immediately results, is safe and effective for most people, with results lasing around a year. Scupltra’s results are delayed and gradual, not an option for individuals with autoimmune diseases or take an anti-inflammatory medicine regularly, lower maintenance, and lasts about 2 years.

Myths about dissolving filler

I’m sure you have heard that dissolving filler is an option if you don’t like it, and while that is partially true there are a lot of myths surrounding that!

What are Fillers?

Hyaluronic acid (HA) fillers are sterile gels consisting of non-animal stabilized hyaluronic acid for injection into the skin to correct facial lines, wrinkles and folds, for lip enhancement, shaping facial contours, etc.

Why Would Someone Have to Consider Dissolving Filler?

The worst case scenario with any filler procedure is what’s called vascular occlusion- basically when filler is injected inadvertently into a blood vessel, blocking blood supply to its target tissue, ultimately leading to tissue death and necrosis if not corrected quickly. That is where hyaluronidase comes in. Hyaluronidase (hyalenex) is an enzyme that breaks up hyaluronic acid and essentially aids in dissolving filler. We always keep it on hand in the worst case event that we experience a vascular occlusion. Flooding the affected area with hyaluronidase is the best bet to restoring blood flow to the tissues.

Aside from vascular occlusions, occasionally fillers produce unwanted aesthetic outcomes, as no cosmetic procedure has guaranteed results. In rare cases, these undesirable effects can be treated with hyaluronidase, however this does carry risks of its own.

We have HA in our body naturally, and hyaluronidase is not selective when it comes to what HA it dissolves- it just dissolves everything in its path. So, while we may only try to dissolve a small bump of filler, there is no guarantee that the hyaluronidase won’t dissolve the native HA in your surrounding tissues. This can leave you with an unwanted deficit or even skin laxity in or around the treated area.


dissolving filler

Patience is Key

The best bet to treating an unwanted outcome is patience- over time (usually 6 months to 2 years depending on the product), your body will absorb the HA filler and the unwanted effects will go away, but on the flip side there is no guarantee that over time your body’s natural HA will be regenerated if a deficit is created from using hyaluronidase.

So yes, HA fillers are reversible, but not without consequence. Our hope is that you are pleased from the get go with your cosmetic outcomes, however no result is ever guaranteed, and there are risks associated with “dissolving filler”. Our advice is to know the risks of filler beforehand, be ok with those risks, and have patience if something does not look exactly how you had hoped. Sometimes doing too much to try to “fix” things just makes the problem worse or creates new problems, and we are left chasing our tails. Of course, our team will always do everything we can to make you pleased with your appearance and loving the skin you’re in! dissolving filler dissolving filler

What is the difference between neurotoxins and fillers?

One of the most common questions we get is “What is the difference between neurotoxins and fillers? And which one is right for me?”.

Neurotoxins (NTs), or neuromodulators, are injectables made up of different forms of botulinum toxin, which when injected relax the targeted muscle. Brands include botox, dysport, jeuveau, etc. Relaxing dynamic muscles helps prevent static lines from forming over time in areas such as the glabella (11s), forehead, and crow’s feet (lines around the eyes). NTs can also help to smooth out lines that have already formed in these areas, but only to an extent. Once a line is there at rest, it is much harder to get it to completely go away, so NTs are actually best for wrinkle prevention!

Fillers are injectables made up of hyaluronic acid (HA) (with a few brand exceptions such as Radiesse), which when injected can provide structure, volume, and contouring. Brands include Restylane, Juvederm, Belotero, etc. Fillers are mostly used to treat something that has already happened, such as volume loss to cheeks that can cause the face to sag and create jowls or to fill a line caused by a dynamic muscle that has not been treated preventatively with neurotox!

So which treatment is right for you? That all depends! Everyone, no matter how old or how young, can benefit from wrinkle prevention with neurotox. A skilled injector at Accent Aesthetics can help decide if fillers are a good option for you as well.

What You Should Know About Hyperdilute Radiesse (HDR)

Wondering what all the hype over hyperdilute radiesse (HDR) is about? Here’s everything you need to know about this new favorite injectable anti-aging/pre-juvenation procedure.

Radiesse is a filler made up of calcium hydroxylapatite (CaHA) microspheres- which is different than your traditional hyaluronic acid (HA) fillers such as Juvederm and Restylane products. The difference? When Radiesse is injected, your body metabolizes the CaHA microspheres, stimulating collagen and elastin production. Loss of collagen and elastin is one of the leading causes of aging, so stimulating our body to ramp up production of these leads to visibly smoother, firmer, and younger looking skin. Traditional HA fillers simply add volume and structure where injected. HA fillers are like a band-aid in a sense, whereas HDR is treating the actual problem.

Who is a good candidate for Hyperdilute Radiesse treatment?

Everyone! HDR can be used for pre-juvenation, helping to slow the aging process, or it can be used to treat an area already showing signs of age such as skin laxity and fine lines/wrinkles. The Radiesse is simply diluted down differently depending on each individual’s goals.

Where can HDR be used?

Everywhere! Most commonly we see HDR used on the face to address thinning skin, fine lines, and sagging that causes jowls, and on the neck to address “turkey neck” and “tech neck”. But HDR can also be used to treat unwanted cellulite, “bat wings” from sagging skin on the backs of the arms, dimples, and even that stubborn upper knee laxity.

What is the downtime?

Thankfully very little to none! Depending on the area treated, some bruising/swelling can be expected, but on the face and neck especially most people experience virtually no visible signs of having any procedure done. Some report mild soreness for a day or two post-procedure, but nothing a little Tylenol or ibuprofen can’t handle.

When do I see results?

Collagen production post-procedure takes about 6 weeks, and most people need 1-3 treatments 6 weeks apart followed by 1 treatment per year for maintenance for ideal outcomes.

We can’t wait to see you for HDR! Contact us to book your first consultation.

gallery, hyperdilute radiesse
Gallery, AdvaTx, Hyperdilute Radiesse, Intracel, Ultherapy, Neurotoxins, chemical peels, IPL, Genesis, microneedling

Essential Wedding Skincare: Tips to get that gorgeous bridal glow!


So many people dream of that special day. And 100% of the time, that dream includes gorgeous, glowing skin.

Just like a wedding,  beautiful skin takes planning and patience. We love working with Dermatologists because together we can address serious issues such as cystic acne, rosacea, melasma and scarring. And if you’re already starting with non-problematic skin we can keep it that way and get it looking even better!

Here are our recommendations for achieving the skin you want on your BIG day!

#1: Come in for a professional consultation. 

This is the first place any bride or groom should start on their journey to gorgeous skin. Ideally this would happen 6-12 months  before the wedding date. Skin issues can be stubborn and take time to remedy. The sooner we start, the more relaxed the process will be. We can address all of your skin concerns, set up a scheduled timeline of treatments and start you on a premium skincare regime at home.

If your considering injectables for dark circles, wrinkles or to add volume to the face, start sooner than later. A good injector will need time to see what and how much of a product works.

#2: Stay consistent with your skincare regime.

A consistent morning and evening skincare regime is what will give you long term results. Many home-care products work better over time, so you must be diligent and consistent! While these products are often medical-grade and very active, they are going on the skin and take time to penetrate and achieve desired results. This is also why it’s important to start this journey early on so we can see what works and what doesn’t in your home-care regime.

#3: Set up a skincare treatment plan and stick to it.

Together we will create a time line of treatments best suited to your needs. Every person is different and has different issues to address. If your concern is acne, you may need to have an exfoliating and extracting treatment done every 2-6 weeks to get it under control.

If Laser Hair Removal is at the top of your priority list, it’s important to start 6 months to 1 year before the big day, depending on the area being treated.

Other skin concerns require monthly or every other month treatments.

A month or 2 before your wedding, we will really “fine tune” your skincare plan, making sure you look your absolute best!  Laser Genesis gives the skin a beautiful rosy glow right before the special event. HydraFacial can plump and hydrate the skin a few days before and AquaGold gives a luxurious “Red Carpet” luminous, finishing touch to skin about a week before the big day.

#4: Don’t neglect your neck, decollete’ and back.

Chances are you’ll be wearing something that will highlight one or all of these areas. The skin in these areas can be different from the skin on your face and require different treatment. Talk to your Aesthetician about your vision and your planned attire. We offer many treatments for these often neglected areas. Together we can make you glow from head to toe!

#5: Get your mind and body right!

It’s important to FEEL your best, so let’s talk about stress reduction, healthy diet and water intake. All of these things are important to not only get your skin looking it’s healthiest but to ensure you’re keeping it that way.

Planning a wedding is in the TOP 5 most stressful situations a person can go through, next to moving and death! WOW!

To avoid a complete breakdown, sleep, nutrition and a healthy diet will be a lifesaver and assure your skin is in tip top shape.

Working in western medicine, there truly are no conclusive studies linking nutrition and skin conditions, BUT I think we all know in our hearts and minds that what we put in our bodies shows up on our skin. So through this journey we will discuss what may be effecting certain skin issues and start the process of elimination.

#6: Go with the best makeup artist: If your looking for an amazing Colorado Makeup artist, I’m linking one here:

Brook at Antlers and Rose’ is an amazing makeup artist based out of Vail, Colorado. She is also an amazing stylist, lifestyle blogger, wife, mother and human! Check out her website and all of the services she has to offer. She is simply the best!





Beyond Botox….

I think by now we all know there is no miracle in a bottle, and botox has been the closest thing we have seen to astonishing results with minimal side effects.


However, optimum skin health goes beyond botox.  It is similar to the health of our bodies- to be optimally healthy you have to work on several factors- diet, cardio and strength training.  Having youthful healthy skin is much the same. IF you only do botox, you are only addressing one aspect of what takes place as we age. The aging face is multifactorial and thus your anti-aging treatments should be so as well. Bone loss, descent of fat pads, skin texture changes, dermal thinning and photodamage all contribute.  When you work with a dermatologist and their staff, you are offered non-invasive treatment options to address these different aspects of aging.


Technology advancements in the field of cosmeceuticals has brought us amazing topical skin care products.  I recently attended a conference where a scientist was reviewing various ingredients/ peptides and said to conduct the research, develop best formulations and then bring those highly active ingredients to market costs money!  If you are getting a Vitmain C serum on Amazon for under a certain price point- do not expect much change to your skin.  Even when we find highly effective products it is good to change your regimen every so often.  We do not like to use growth-hormone products long term and not every person can tolerate tretinoin.  So partner with someone who can help you achieve your best! Last but not least- healthy inside will reflect healthy outside- clean eating, restful sleep, adequate water intake, physical exercise…..and wear an SPF 30 on your face daily!


I always tell patients our goal is find the treatments that will give the most bang for the buck and find the balance between a treatment that is highly effective while still being safe.  You want to partner with a skincare expert who attends educational events, stays up on current trends, has access to multiple modalities to use and works alongside a Board-Certified Dermatologist or Plastic Surgeon to minimize unwanted side effects.  Look for someone who will be candid, give realistic expectations and instead of trying to sell you something- will give you both short term as well as long –term goals for your skin.


Written by Kerri Zukosky, PA-C