title: Calcium hydroxylapatite: A review on safety and complications.
abstract: BACKGROUND
  Radiesse®, or calcium hydroxylapatite (CaHA), is a biodegradable, biostimulatory soft tissue filler suitable for deeper folds and wrinkles. In the literature, good results have been documented with the use of CaHA and patient satisfaction scores are high. This study reviews the current literature on safety and complications of CaHA.
  
  
  METHODS
  A literature search in MEDLINE/PubMed electronic database was conducted. A total of 21 articles were included and screened for reports of adverse events (AEs).
  
  
  RESULTS
  Twenty-one peer-reviewed articles, published between 2004 and 2015, were included. A total of 5081 treatments with CaHA were performed on 2779 patients. A total of 173 (3%) AEs were reported. The assessed types of AEs consisted of nodules (n=166, 96%), persistent inflammation/swelling (n=4, 2%), persistent erythema (n=2, 1%), and overcorrection (n=1, 1%).
  
  
  CONCLUSIONS
  Based on the results in this study, CaHA appears to have a good safety profile. Nodules are by far the most common AE. Of the reported nodules, 49% occurred in "dynamic" areas currently known for having a higher tendency for nodules. Several treatment approaches exist for managing CaHA nodules; however, in most cases, CaHA nodules are not visible and resolve without intervention.
authors.affiliation: Mohs Klinieken Amsterdam, Amsterdam, The Netherlands.
authors.forename: J A
authors.identifier: http://orcid.org/0000-0001-5543-5675
authors.initials: JA
authors.lastname: Kadouch
mesh_terms: D001672:Biocompatible Materials / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000009:adverse effects*; D017886:Durapatite / Q000009:adverse effects*; D006801:Humans
chemical_list: D001672:Biocompatible Materials; D000067548:Dermal Fillers; D017886:Durapatite
keywords: calcium hydroxylapatite; complications; radiesse; safety; soft tissue fillers