Hello, this is Lifton Dermatology.
Recently, I attended the Merz Radiesse TTT seminar. It was a gathering of physicians who provide Radiesse training, and it was an impressive session with in-depth discussions about Radiesse.
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To get to the main point...
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Among those who visit because they want lifting, many actually need tightening rather than lifting. To put it simply, it is skin that feels loose and soft rather than sagging downward.
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These are people who, as shown in the photo, develop shallow, layered wrinkles around the mouth when making facial expressions. These are called accordion wrinkles. They fold like an accordion, and this is a characteristic of people who do not have much facial fat but have lost elasticity.
For such people, it can be burdensome to do excessive lifting with Ulthera. Especially if there is little fat, performing treatment with the 4.5 mm or 3.0 mm tips can make the face look even more hollow and less attractive.
So, in general, people either get elasticity-focused Ulthera using only the 1.5 mm tip or get Thermage.
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However, as those who have received it consistently will know, Thermage is a very good treatment for improving elasticity, but it does not solve everything. In addition to heat, there is definitely a need for chemical action as well. That role has been played by skin boosters.
That is why treatments are combined with Thermage, such as Thermage + Rejuran and Thermage + Juvelook. More recently, we have been treating many patients with combinations such as Thermage + Radiesse or Ulthera using the 1.5 mm tip + Radiesse.
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The procedure is simple.
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There is almost no downtime.
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The results are good.
For these reasons, it is often recommended.


The actual injection area is spread broadly with a cannula just below the dermis, so there is no embossing, and because there is no need to inject many times, it does not affect downtime.
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This type of treatment seems to work even better on the neck. Personally, because the skin on the neck is very thin, I tend to recommend being very proactive with skin boosters even when doing Thermage. Rather than repeatedly puncturing with injection needles in an uncomfortable way, spreading a collagen booster with a cannula seems very good in terms of downtime as well. (Since the cannula passes through the entire neck, there may also be a mechanical effect.)

Radiesse, injected beneath the dermis, diffuses and affects the dermis, and unlike Juvelook, it directly induces collagen production without causing significant inflammation.
The recommended treatment interval is once every 1 to 2 months.
Therefore, when planning a treatment schedule...
Ulthera/Thermage + Radiesse --1 month later--> Radiesse boosting --1 month later--> Radiesse boosting
If you do it this way, you can maintain better results.
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