The demand for non-surgical rejuvenation treatments has grown significantly, so more and more products appear on the market. Among the many dermal fillers available, Ellansé and Radiesse stand out for their ability to provide both immediate enhancement and long-term collagen stimulation.

Undoubtedly, hyaluronic acid fillers remain popular for their temporary and reversible effects, but these two biostimulatory fillers offer a different approach — one that focuses on natural regeneration for results that last well beyond the typical filler lifespan.

Choosing between Ellansé and Radiesse is a complex decision, which hinges on an understanding of their distinct compositions, mechanisms of action, and ideal applications. Their differences in formulation and best-use scenarios make them suitable for different patient needs.

We decided to compare Ellansé and Radiesse directly, breaking down their key benefits, how they work, safety considerations, and which patients might benefit most from each option.

Overview of Ellansé

Ellansé is a next-generation dermal filler distinguished by its unique composition and dual-action mechanism. It consists of smooth polycaprolactone (PCL) microspheres suspended in a carboxymethyl cellulose (CMC) gel carrier. The CMC gel acts as a temporary scaffold, providing immediate volume restoration upon injection.

As the gel gradually resorbs, the PCL microspheres remain in place, triggering a controlled inflammatory response that stimulates fibroblasts to produce new collagen (a process known as neocollagenesis.) Over time, this leads to enhanced skin firmness, elasticity, and volume.

Unlike hyaluronic acid (HA) fillers, which work by attracting water molecules to plump the skin, Ellansé actively remodels the dermal matrix. The result is long-term structural reinforcement of the skin.

Treatment Applications

Ellansé is widely used in aesthetic medicine for its versatility. Due to its ability to induce collagen synthesis, it is particularly effective for patients seeking long-term structural improvements. Key applications include:

• Facial Volume Restoration: Ellansé is commonly used to restore lost volume in areas such as the cheeks, temples, and jawline.
• Wrinkle Reduction: The filler effectively smoothes deep facial wrinkles, including nasolabial folds and marionette lines.
• Skin Laxity Improvement: By stimulating collagen synthesis, Ellansé enhances skin density and resilience.

Longevity of Results

One of Ellansé’s most significant advantages is its extended longevity. Clinical studies have shown that depending on the specific variant used (Ellansé-S, M, L, or E) results can last from one to four years.

The duration of results varies based on several factors, including:

• The selected Ellansé product variant (longer-lasting formulations contain larger PCL microspheres).
• The patient’s metabolic rate and lifestyle factors.
• The injection technique and depth at which the filler is placed.

Safety Profile and Side Effects

As with any injectable treatment, Ellansé carries potential side effects, although the majority are mild and transient. Common reactions include:

• Temporary redness, swelling, and bruising at the injection site.
• Mild discomfort or tenderness, which typically subsides within a few days.

Severe complications, although rare, can occur and may include:

• Nodule Formation: In some cases, excessive collagen stimulation or improper injection technique can lead to palpable nodules beneath the skin. These are often manageable with massage or medical intervention.
• Vascular Compromise: Incorrect injection into or around blood vessels can lead to vascular occlusion, resulting in skin necrosis or other serious complications.

Overview of Radiesse

Radiesse is a biostimulatory dermal filler composed of calcium hydroxylapatite (CaHA) microspheres suspended in a water-based gel carrier. The gel provides immediate volume and structural support upon injection. Over time, as the gel carrier is gradually absorbed, the CaHA microspheres stimulate fibroblast activity.

Hyaluronic acid (HA) fillers rely on water retention to plump the skin, yet Radiesse actively reinforces the dermal matrix. The collagen-building properties make it particularly useful for patients experiencing age-related volume loss and skin laxity.

Radiesse is unique in that it can be hyperdiluted with saline and lidocaine to function as a collagen-stimulating skin booster. In this diluted form, it is used to improve skin texture, elasticity, and overall quality rather than providing volume.

Treatment Applications

Radiesse is a versatile filler with a range of applications.

• Facial Contouring: Radiesse is frequently used to define and enhance facial features, including the cheeks, chin, and jawline. Its firm consistency allows for precise sculpting.
• Hand Rejuvenation: Radiesse is FDA-approved for use in the hands, where it effectively restores volume lost due to aging. The hands often betray signs of aging earlier than the face, as they lose fat and become more skeletal in appearance. Radiesse replenishes this lost volume.
• Skin Rejuvenation (Hyperdiluted Radiesse): When diluted, Radiesse is used as a biostimulatory skin booster.

Longevity of Results

Radiesse also has extended duration compared to regular HA fillers. Radiesse provides results lasting over a year, depending on treatment area, metabolic rate, injection technique, and other factors.

Safety Profile and Side Effects

As with Ellansé, Radiesse carries some risks, but it’s overall safe. Mild to moderate swelling, redness, and bruising at the injection site are not a cause for concern.

If patients notice small, firm lumps beneath the skin, you should suspect granuloma formation and potentially vascular complications as well.

Head-to-Head Comparison: Ellansé vs. Radiesse

We have gone over the most important individual characteristics, and let’s see how it looks in a direct face-off.

Composition and Mechanism

Ellansé is formulated with polycaprolactone (PCL) microspheres suspended in a carboxymethyl cellulose (CMC) gel carrier. The gel provides immediate volumization upon injection, while the PCL microspheres gradually stimulate collagen synthesis. Over time, the body metabolizes the gel, leaving behind newly generated collagen.

Radiesse, on the other hand, consists of calcium hydroxylapatite (CaHA) microspheres suspended in a water-based gel. Similar to Ellansé, Radiesse gives immediate volume upon injection, but its CaHA microspheres function slightly differently. They create a temporary matrix that supports collagen production while gradually being absorbed by the body. So, it’s a dual action.

Treatment Applications

Ellansé is primarily indicated for facial volumization and deep wrinkle correction. It is particularly effective in treating cheeks, temples, jawline, and nasolabial folds. Radiesse is also highly effective for facial volumization but has an additional FDA-approved indication for hand rejuvenation.

Longevity and Maintenance

One of the key differences between these two fillers lies in their longevity. Ellansé is known for its extended durability, with results lasting up to two years or more, depending on the specific variant used and the patient’s metabolism. Radiesse, while still longer-lasting than traditional hyaluronic acid fillers, typically provides results for approximately 12 to 18 months before a touch-up.

Safety and Side Effects

Both Ellansé and Radiesse have well-documented safety profiles and are generally well-tolerated by patients. Common side effects include mild to moderate swelling, redness, bruising, and tenderness at the injection site, which typically resolve within a few days. These fillers are also non-immunogenic, meaning they do not trigger allergic reactions in most patients.

However, one of the most important considerations with both fillers is that neither can be reversed with hyaluronidase. Unlike hyaluronic acid fillers, which can be dissolved if needed, you can get rid of Ellansé and Radiesse so easily.

Considerations for Medical Professionals and Clinics

Don’t fail to analyze all these things that can significantly affect the entire process.

Patient Assessment

Medical professionals should evaluate the patient’s medical history, skin condition, lifestyle, and aesthetic goals to determine the most appropriate filler. Skin elasticity, volume loss, past cosmetic procedures, and metabolic rate can influence how well a patient responds to a particular product. Also, it is crucial to screen for any contraindications, including autoimmune conditions, allergies, active skin infections, or a history of severe scarring or keloid formation.

Training and Expertise

Proper training and technical expertise are essential for achieving satisfactory results. Both Ellansé and Radiesse require precise injection techniques that differ from traditional hyaluronic acid fillers. Practitioners should undergo specialized training in product-specific injection depths, techniques, choice of cannula or needle, and placement strategies. For instance, Ellansé requires a deep dermal or subdermal injection for effective collagen stimulation, while Radiesse, depending on the treatment indication, can be injected superficially when diluted or deeper for structural support.

Product Selection

Patients who prefer a progressive, natural collagen boost with fewer touch-ups may lean towards Ellansé, whereas those who want an adaptable filler that can be used both for volumization and skin texture enhancement might opt ​​for Radiesse. Anyway, the decision must never be solely the patient’s.

Long-Lasting Dermal Fillers

Traditional fillers provide temporary results that require frequent touch-ups, while long-lasting fillers such as Ellansé and Radiesse go a step further. Along with giving immediate volumization, they also trigger the body’s natural collagen production.

Patients and practitioners alike are increasingly turning to long-lasting fillers due to their multiple advantages over short-term alternatives. Here are some of the key benefits:

• Extended Efficacy: Unlike traditional hyaluronic acid fillers, which may break down within six to twelve months, long-lasting fillers can maintain their effects for one to four years, depending on the formulation.
• Cost-Effectiveness: Although the initial cost of long-lasting fillers may be higher, their durability translates to long-term savings. With fewer treatments required over time, patients can achieve their desired look without repeated expenses.
• Natural Results: One of the key advantages of biostimulatory fillers like Ellansé and Radiesse is their ability to enhance the skin naturally. Instead of simply filling wrinkles or hollow areas, these fillers boost collagen production. As a result, the enhancements appear more subtle and natural.

Final Thoughts

Ellansé and Radiesse are two of the most advanced dermal fillers available today. Unlike traditional hyaluronic acid fillers, which primarily address immediate volume loss, these biostimulatory fillers provide lasting benefits that continue to improve skin quality long after the initial treatment. That is exactly why they are in demand.

Yet, they are not immaculate and in order to use their maximum potential, we have to understand a lot of things.

Ellansé’s unique polycaprolactone (PCL) microsphere technology gives practitioners flexibility in choosing a formulation that best suits each patient’s needs. Radiesse, with its calcium hydroxylapatite (CaHA) composition, provides an immediate volumizing effect while also working as a scaffold to encourage collagen production.

For medical professionals, knowing these distinctions is key to providing the best possible treatment plan. Also, always follow new innovations that can help.

 

Frequently Asked Questions (FAQs)

What are the key benefits of using long-lasting fillers over temporary ones?

Long-lasting fillers reduce the need for frequent touch-ups, making them more cost-effective in the long run. They also offer gradual, natural-looking improvements by stimulating collagen. On top of that, longer-lasting fillers are ideal for deeper volume loss and structural support.

How do dermal fillers compare to other anti-aging treatments like Botox or laser therapy?

Dermal fillers restore lost volume and smooth wrinkles, while Botox relaxes muscles to prevent expression lines. Laser therapy targets skin texture, pigmentation, and collagen remodeling. In many cases, these treatments complement each other, with fillers providing volume, Botox reducing dynamic wrinkles, and lasers improving overall skin quality.

What areas of the face and body can be treated with dermal fillers?

Fillers are commonly used to improve cheeks, lips, nasolabial folds, and jawline. They can also restore volume in the hands, rejuvenate earlobes, and even improve the appearance of scars. Some advanced applications include non-surgical rhinoplasty and skin tightening in the neck and décolletage.

Can dermal fillers be used to treat acne scars or other skin depressions?

Yes, certain fillers, particularly HA and CaHA-based products, can improve the appearance of atrophic acne scars and skin depressions. They work by lifting indented scars and promoting collagen remodeling. However, results vary based on scar type, and some patients may require combination treatments like microneedling and laser therapy.

What should patients avoid before and after getting dermal fillers?

Before treatment, patients should avoid blood-thinning medications, alcohol, and supplements like fish oil to minimize bruising. After injections, they should refrain from strenuous exercise, excessive sun exposure, and facial massages for at least 24-48 hours to prevent complications.

 

References

Chen Q, Wang Y. Ellansé: Advanced Technology and Advantageous Selection of New Collagen Stimulating Agents for Face Rejuvenation. Aesthetic Plast Surg. 2024 May;48(10):1977-1984. doi: 10.1007/s00266-023-03761-w. Epub 2024 Feb 2. PMID: 38305923.

Aguilera SB, McCarthy A, Khalifian S, Lorenc ZP, Goldie K, Chernoff WG. The Role of Calcium Hydroxylapatite (Radiesse) as a Regenerative Aesthetic Treatment: A Narrative Review. Aesthet Surg J. 2023 Sep 14;43(10):1063-1090. doi: 10.1093/asj/sjad173. PMID: 37635437; PMCID: PMC11025388.

de Melo F, Nicolau P, Piovano L, Lin SL, Baptista-Fernandes T, King MI, Camporese A, Hong K, Khattar MM, Christen MO. Recommendations for volume augmentation and rejuvenation of the face and hands with the new generation polycaprolactone-based collagen stimulator (Ellansé®). Clin Cosmet Investig Dermatol. 2017 Nov 8;10:431-440. doi: 10.2147/CCID.S145195. PMID: 29184426; PMCID: PMC5685142.