Episode #26: Radiesse and Hyper-Dilute Radiesse

In this episode, we take a closer look at one of the most versatile injectables in regenerative aesthetics: Radiesse. Whether used to restore volume and structural support or diluted to stimulate collagen in more delicate areas, Radiesse offers both immediate enhancement and long-term skin rejuvenation. We will explain how Hyperdilute Radiesse works as a biostimulatory treatment, how it differs from traditional fillers, and which areas benefit most, such as the face, neck, arms, upper thighs and zones with crepey skin.

 If you have ever wondered how to rebuild your skin’s foundation in a natural and regenerative way, this episode will guide you through it. 

Thank you for your listenership!

Transcript

Kane Rogers 0:11

Hi everyone. I hope you're doing well. Thank you for joining us for another episode of Just Laser and all things Cosmetic. And truth be told, this is the second time we're running through this because I did not push record on the first

Dr. Minni Saluja 0:25

don't need to tell everybody that

Kane Rogers 0:27

Well, I want them to know that this is still a bit of an amateur.

Dr. Minni Saluja 0:30

this, this to be much, much

Kane Rogers 0:31

No, but they didn't know what it was the first time

Dr. Minni Saluja 0:33

it was bad.

Kane Rogers 0:34

No. today we're gonna discuss Radius.

Dr. Minni Saluja 0:40

I like Radius. it's a great product.

Kane Rogers 0:42

I like Radius too. And, and I'm gonna go through the reasons. Kane, can you hear me by

Dr. Minni Saluja 0:47

Yes, I can.

Kane Rogers 0:48

so the difference, so what is Radius? Let's start with that. Radius is calcium hydroxyl appetite, which is basically the mineral component of bone that is in a syringe. 30% of it is this calcium hydroxyl appetite. The rest is a carrier gel carboxy Methylcellulose.

Dr. Minni Saluja 1:07

so it's a very small micro mineral component.

Kane Rogers 1:11

it's 30% of

Dr. Minni Saluja 1:12

see chunks of stuff floating around

Kane Rogers 1:13

No, but when you see it, it looks like toothpaste. It looks like white toothpaste when you see it. But the particles are really small. They're about 25 to 45 microns in size. Teeny, teeny, tiny, particles. And the reason why I love Radis so much is because in one syringe, I basically have an entire product portfolio. And what I mean by that is that I can either. Keep it in its intact form and not dilute it out, and it has a really high G Prime. Do you know what I mean by that? Kane? Not So g, the G prime of a product, we hear that with fillers and Radius is classified both as a filler and a bio stimulator. But the G prime is basically the stiffness of the product, the non-con conformability of the product. And so if you have a very stiff product, you can use it to kind of anchor up tissue, and add volume in a very. Kind of cut way, so to speak. So it's great for the jawline, for the cheek area down to the bone, down to the periosteum, to try to fill those areas.

Dr. Minni Saluja 2:22

So it's a little bit of a stiffer filler. Correct. You wouldn't want to put it in

Kane Rogers 2:26

No. Nope.

Dr. Minni Saluja 2:27

cause you want lips or malleable and you want them moving around

Kane Rogers 2:30

Correct. For the lips. I like my UR acid. That is a molecular sponge. It's basically pulling in water so it keeps it nice and soft. But radius again, is even in its intact form in the sense when it's not hyper diluted, it still is a bio stimulator, but it's more of a filler. It you, it veers more to that side of it. But then when I wanna really stimulate some collagen and elastin, I take that same syringe. I put in three times the amount of bacteria, static saline with a little bit of lidocaine. We intermix that into the syringe, and now it changes the properties altogether and it lowers the G prime and it's meant to basically canvas the area of whatever we're treating, whether that's the face or the neck or other body areas, and it lays down. So basically you're getting more surface area. Or a surface contact, I should say, where the fibroblasts can then interact with these little tiny molecules to produce collagen and elastin.

Dr. Minni Saluja 3:31

So you can go from. Using it almost strictly as a filler to all the way to just as a biostimulatory, to a biotin, to where it's stimulating both collagen and elastin. Which is important that it stimulates both, right?

Kane Rogers 3:48

That's correct. And what if you, you know what, if you're a patient, you say, well, I want both. Well, that's easily done. You start off by doing the areas that you want to fill or lift. And you do that with. Non diluting it. So you take a little, you start it off

Dr. Minni Saluja 4:01

the product

Kane Rogers 4:02

as you get it. And then as I'll put a little bit to, let's say on the cheek area, the jawline, and then I'll hyper dute it for the rest of the face. And for example, in the peri oral area, those fine lines and wrinkles and even the deeper lines in the peri oral area are wonderful then to treat as well.

Dr. Minni Saluja 4:18

Now, can you modulate the hyper, dilute the level of hyper dilution that's, so you could do really hyper diluted or just kind of somewhat

Kane Rogers 4:26

Oh, sure, sure. Now you can't go back once it's diluted, you know, for that product. But yes, you can march along and you might say, okay, let's say if I'm treating legs and I see a little bit of, cellulite, I might have a one to two dilution there, but then if I wanna just stimulate elastin and collagen for the upper thigh area, then I might take it to a one to four dilution.

Dr. Minni Saluja 4:42

So it's very, very flexible from being just a filler. Or just a biostimulatory

Kane Rogers 4:48

Correct. The only thing I can't do is lips with it.

Dr. Minni Saluja 4:51

you're kind of getting two for one with this. You're getting a filler and or a biostimulatory and or something. In both

Kane Rogers 4:58

correct. So you know that I don't inject noses, I don't inject under the eyes and the noses because the vascular rich area that can feed back and cause blindness. I don't inject the glabella area. There's other things that we have that can do that, but I love the hyper dilute radius, as a component just to make sure that we're really improving the quality of the skin

Dr. Minni Saluja 5:19

But it does take a certain degree of knowledge and skill or art even to knowing, Hey, I'm gonna use it just as a filler here. I'm gonna hyper dute it this amount here and I'm gonna really hyper do it for another place. I mean, it takes a lot of knowledge and knowhow and skill, I would

Kane Rogers 5:35

Sure. And you know, you wanna be able to look at the patient's face and certainly ascertain what areas that you wanna treat in what direction. So, absolutely. And what's important to note too, is is it a one and done Well, no, it's not. It, it just like Sculptra can take one. Vial per one bottle per decade of life. This is a little less than that. I almost tell patients, okay, we might need one syringe per every two decades of life. So if someone's 60 years old, they might need three sessions with one syringe being done. So I might do them on the first day. Six weeks to two months later, I might do another syringe, and six weeks to two months later I might do a third syringe. But you march along slowly so you can see if goals are achieved, because I might say, Hmm, you might need three sessions and they're happy with two. So if you march along slowly, you can appreciate the level of collagen

Dr. Minni Saluja 6:25

gonna say. I would imagine there might be some patients or even some injectors that would just rather do two or three right at once, right out of the gate.

Kane Rogers 6:32

Well, I'll tell you now, I will do two or three. If someone has an ozempic face where they've lost a lot of volume, and then we might put two syringes in or three syringes in at that same level because I know that they need that much to replace. That might be the only time that I do that if there's significant volume loss or if someone, maybe they haven't. They are not on ozempic or anything, but they have lost weight or they just have never had,, any type of volume replacement before. And their face may need that.

Dr. Minni Saluja 7:02

So, but that's why it's important to probably go slow because people are gonna respond differently. And so you really don't know what the results are gonna look like for. A couple of months down the

Kane Rogers 7:12

have an idea, but you don't know where you're gonna make them happy. Meaning some people might want a little less further collagen la you know, they might say, Hey, I just wanna look a little more refreshed. Others might say, no, these upper lip wrinkles drive me crazy. Let's do another session. So that's how you can kind of evaluate and see. But it is important to note that. when you do this, I always have patients, I make sure that they take a little bit of oral vitamin C because remember oral vitamin C just 500 milligrams a day for the first six weeks or so is a co-factor for building collagen. So I think that's important to have, you know, good diets, important to have as you're doing this as well. One of the areas, Kane, so you were asking about the stimulatory effect is the neck. I really love it for the neck because you can then take a cannula, you know, you take little areas, you, you put a little bit of numbing, you can go into those areas and you don't wanna add volume per se unless there's a little bit of a fine necklace line, but you want to be able to stimulate the collagen. So it's wonderful for that area and the tage area as well.

Dr. Minni Saluja 8:17

Now you specifically mentioned the cannula. Why is, why did you mention that? What's that important about

Kane Rogers 8:22

Well, when I'm, when I'm trying to canvas the area, I like to go in one area, one opening, and fan it out all over the face or all over the neck area and cannulas, of course. Now this is all subdermal, so it's right under the dermis is not down,, deep in the vasculature. when you do a periosteal, non-diluted technique, I do a needle there and I hit the bone because remember, that's the important part where there's no vessels is down deep in the bone or just right underneath the skin. So. Because again, you don't wanna cause an intervascular occlusion, which is the dreaded complication of any filler. but you have to know your anatomy of where you are to minimize that. And when you're in an area, you wanna use a cannula to try to minimize that risk.

Dr. Minni Saluja 9:08

Okay. Now I heard you mention vascular, which makes me think of bruising. So is this something that you can bruise with quite regularly, or, because you are just going. Just underneath the dermis, is it less likely to bruise?

Kane Rogers 9:20

Nope. You can still bruise. I mean, there's vessels everywhere. Little tiny vessels cosing all throughout our skin. Little tiny ones. certainly you wanna stay away from the big, deeper ones, but. No patients can bruise. Anytime you put a needle anywhere, even if it's Botox, there can be a risk of bruising. And granted, we try to minimize that to the best that we can. We even have an ACU vein in the practice to try to minimize it. But bruising can occur and that's not the end of the, you know, that's not a. Anything to be concerned about, but it's something to, I always say, give yourself a grace period in case you have, if you want to sign up for something like this, don't do it right before a wedding the next day. You know, try to give yourself a little bit of a grace period. That way there's not stress over a bruise.

Dr. Minni Saluja 10:03

Okay. Now you mentioned Ozempic face and one of the things that comes up a lot is Ozempic face and Ozempic, but is this something that you would use, in the booty as well, or other body parts?

Kane Rogers 10:14

Oh, sure. I mean, in fact, I specifically use radius when it comes to ozempic faces because I don't want the puffiness of an ha, but I want the fill there, and I definitely wanna be able to stimulate some elastin and collagen because of Ozempic. When you lose a lot of weight, you get that laxity that you see. So you wanna be able to not just fill, but improve the quality of the skin as well. So I think you can get to gold better with radiuses than, than some of the other products.

Dr. Minni Saluja 10:42

And even on the backside,

Kane Rogers 10:44

And even on the backside now, when you're talking about a butt lift, for Mozambique butt, it does require multiple syringes. I mean, it's not uncommon to have 20 syringes placed in the buttock area depending on how much has been lost.

Dr. Minni Saluja 10:57

are you hyper diluting that or is that more of the filler

Kane Rogers 10:59

some of it is hyper diluted. It's usually about a one to two, hyper dilution that's there. If there's a little bit of some, cellulite you might be, doing, you know, one to two. And then you can also hyper dilute to one to four for the rest of the

Dr. Minni Saluja 11:11

So it is important to kind of know what you're doing, if you're the injector to how to hyper dilute it, how much to hyper dilute it when not to and when to.

Kane Rogers 11:19

No, it's, it's what effect you're trying to get. And that's, and that's what's important with how much you hyper dilu diluted or not. But you know, so again, in this syringe cane, this 1.5 milliliter syringe, now, normal fillers or one milliliter, this is already a little bit more, but there's. 33 million of these little tiny calcium hydroxyl appetite particles. So when you hyper dute it, you're basically taking all these 33 million and you're spreading it out so that fibroblasts can then interact with these to produce that elastin and collagen. Okay. So that's what's, what's so important about it.

Dr. Minni Saluja 11:56

And that is important'cause you're stimulating both

Kane Rogers 11:58

You are. And so you know how we're starting to play pickleball ball more and more, but, I look down at my legs and I see that crepey component right above my knee. So I think next weekend I'm gonna do my upper knee area and in my bruise, and I'm okay with

Dr. Minni Saluja 12:13

that. And what are you, what are you expecting to see as

Kane Rogers 12:16

So I'm gonna stand up and so this part right here, I want it to be a little bit smoother. I just want a little bit more collagen to that area and just a little bit of smoothness. That's always, I've always hated my legs and so. Do

Dr. Minni Saluja 12:27

do you think that's just one syringe? What is that?

Kane Rogers 12:29

No, I probably need one syringe per upper thigh area. So when you, when you're thinking about areas like that, you kind of look at the palm of your hand and you think about one syringe per, per the palm of your hand, kind of an outstretched hand. and so I'll probably do one per each side, and I might need a second session at two months, but I'll, I'll let you evaluate that and see,

Dr. Minni Saluja 12:52

Okay.

Kane Rogers 12:54

but.

Dr. Minni Saluja 12:55

My eye is not as discerning as yours, so,

Kane Rogers 12:57

but those are, those are areas that can be done. I mean, some people even do the inner part of their arms as well, but I think my favorite areas, definitely are the face and the neck. I think those, and, and the decollete, I think those areas

Dr. Minni Saluja 13:09

I've always been a fan of Radius just because it is so versatile and it can be used as a filler or a biostimulatory or like I said, and modulate it and it can with the hybrid dilute and it can kind of be a little bit of both. So it's kind of a two for one type of product.

Kane Rogers 13:22

Absolutely. And we also use it in combination therapy. So for example, when I do the neck area, lots of times patients can have very deep necklace lines and crepeness to the neck. I'll first start with the hyper dilute radius, and typically I do it about a one to four dilution on the neck and then, one to three to one to four. And then I will, add like prism plasma on top of it or, Nitrogen plasma, or even some thulium fractional dium, like la d on top of it. So I'll add a second laser on top of it just to try to augment the results even more.

Dr. Minni Saluja 13:57

And just for those of you listening, we do have podcasts on Prism, plasma and Age Jet and Thulium, which is also Las D. So if you, if you're wondering what is she talking about? You can listen to'em,

Kane Rogers 14:08

right? I think it's,, yes. Yes. you'll find them in the,

Dr. Minni Saluja 14:10

I'm, I'm curious, and I don't wanna go on too long here, but I'm curious, like, why did you just name several different devices? when should you just use one?

Kane Rogers 14:19

You can, it's again, dependent on. What I'm trying to achieve, and what patient's down times might be, might guide me one way or the other. Or let's say, for example, there might be a little coloration. Maybe someone has a little bit of dyschromia, some coloration issues. Then I might do a fractional non-ablative laser. The thulium, the la d on that. if they have deeper necklace lines, I might reach for my Prism plasma. I really like that one as well. just different things like that, looking at the patient and trying to decide what their best outcome would be. And the wonderful thing is we do have a lot of these energy based devices that we can decide, maybe this one for this patient or no, this patient might do better. And even microneedling is wonderful as well.

Dr. Minni Saluja 15:02

Okay. Yeah, it's great because there's so much versatility with this, I mean, with Radius, and then using it in combination with other things and the results can be pretty remarkable. and when I think about it, it's almost regenerative in nature, right? it's really targeting your own biology.

Kane Rogers 15:17

Absolutely Cain, and you know, some biostimulators are only stimulating collagen. Well, that's not the true nature of our skin. I mean, if we look at our extracellular matrix, it's not just collagen that we have, it's elastin. It's all those different proteoglycans we have in there. So we wanna be able to target both elastin and collagen to get that, that recoil, that bounce back, that natural component to our skin. Sometimes patients will ask, you know, what does elastin do? I know about collagen, but what does elastin do for my skin? And I tell them this, you know when you get older and you go for a massage and you lay down in the massage on the massage table for about three to four hours, you're walking around with the, the imprint, right. That's the lack of elastin in our skin that we don't get, that recoil bounced back to our skin. So it is equally important. It doesn't get quite the same notoriety that collagen gets, but it's just as important for our skin.

Dr. Minni Saluja 16:13

Okay. No, that's good. And like I said, that all, everything you described is very regenerative in nature, and I like that because it's targeting your own biology to kind of.

Kane Rogers 16:21

Right. I've gotta be, I've gotta kind of give a wonderful nod to the regenerative medicine program that I just completed. So I'm gonna keep that in my heart

Dr. Minni Saluja 16:29

I wasn't even working. I, I promise I wasn't even working in the word regenerative because of that. But yes, I mean, you do have a master's in that, so yeah, it's very

Kane Rogers 16:37

gotta be true, true to it. So anyway, that is radius and hyper dilute radius, one of my favorite things to do in the practice, in a nutshell. and I hope this would record it

Dr. Minni Saluja 16:50

and I'm glad you listened. Hopefully this far. All right. Bye.

Kane Rogers 16:54

Bye.