Ah yes, another filler battle ensues…… People want to know “which is better”. The short answer , to me, is Radiesse. Many well respected dermatologists and plastic surgeons would disagree. Which is fine….this is my blog …they can start their own. The long answer goes like this.  Radiesse and Sculptra are both FDA approved fillers that work best for overall volume enhancements….cheeks , chins, temples, hands, etc.  Both put “air back in the balloon”, so to speak. Both can be used to achieve excellent cosmetic results that depend more on the injector than the substance itself. So aren’t they just interchangeable?…..not so much.   I like Radiesse for several reasons. First, it is a natural substance already found in the body. To date I have seen zero reactions. Sculptra is made of a substance that is foreign and more reactive (many sutures are made of similar material).  I have seen many reactions or unsavory aesthetic results pass through my office, fortunately from other injectors. Sculptra does last longer than Radiesse but I have found it much less predictable – meaning in some patients it disappears too quickly  and doesn’t cause enough of an clinical effect or the filler develops too much and lasts way to long. Much of this lies in the fact that Sculptra must be performed in several treatment sessions with the effect “building’ over time. Radiesse, I inject whatever I need in one treatment session and the results are in general, immediate and predictable.  And finally, Radiesse, I have found, to be much more cost effective for the patients and the physician. In my practice, 1 1.5 cc syringe of Radiesse has been equivalent to one bottle of Sculptra in patient effect. The substance itself is cheaper than Sculptra and the ability to perform all  necessary filling in one treatment session allow the physician to discount the additional syringes used. So there you have it. Being the only juror in this discussion, I am certainly biased. My opinion may change but Radiesse works for me and my patients. Obviously they both exist because there are many that like Sculptra. Only time will tell if one is superior.