Surg Cosmet Dermatol. 2011;3(3):203-205
Introduction: Calcium hydroxyapatite is a radiopaque material that was traditionally used
to provide radiologic contrast. It has recently been approved for use in cutaneous filling.
Objectives: To define the radiologic characteristics of Calcium hydroxyapatite and its
potential to compromise radiologic evaluations.
Methods: Twelve patients received Calcium hydroxyapatite filler in the malar eminence
and had radiography of the face (frontal, lateral, mentum-nasal-plaque (Waters), and Hirtz
axial incidence technique) 1-8 weeks after the procedure. The X-rays were examined by
two radiologists – one of whom was unaware of the filling procedure.
Results: The Hirtz axial incidence technique demonstrated amorphous radiopaque
images in the suprazygomatic soft tissues in all cases, in both evaluations. Radiesse® was
not detected using the other techniques, and did not illustrate the filler''''''''s position and
symmetry. The evaluation of subjacent osseous structures was not compromised by the
material''''''''s presence.
Discussion: Calcium hydroxyapatite can be identified in facial radiography when evaluat-
ed using a method that avoids overlapping with adjacent osseous structures. Although it does
not impair the osseous evaluation, it is recommended that the radiologist or dentist is noti-
fied of the material''''''''s presence.
Conclusion: Cutaneous fillings containing Calcium hydroxyapatite can be identified,
although not precisely located, using conventional X-ray.
Keywords: FACE, DURAPATITE, X-RAYS