Getting older not only takes a toll on our complexion, riddling it with lines, wrinkles and areas of lost volume, but it eats away at our self-esteem and confidence too. Our once smooth, soft and flawless skin becomes riddled with lines, making us self-conscious and discouraged. If you’re unhappy with what the look of line, wrinkles and folds has done to your appearance, call Grossman Dermatology in Santa Monica, CA and ask how Radiesse can transform your appearance.

The Aging Process

Wouldn’t it be nice if our soft, smooth and youthful complexion could last forever? Sadly, the passage of time brings with it structural changes to our skin that cause the signs of aging we’d all sooner live without. The structural changes all have to do with the protein collagen.


Collagen is a strong and fibrous protein that’s responsible for keeping our skin smooth and wrinkle-free. How? It packs firmly together in the middle layer of our skin, or the dermis, forming a solid and wrinkle-free surface which makes our complexion strong. Collagen also helps our skin to be thick and opaque, encouraging quick and healthy cell regeneration, leaving us with an even tone and texture.

Our deepest layer of skin, the hypodermis, is where we have a layer of fat and fat pads that, when tightly in place, give us our youthful contours like high cheekbones, round apples of our cheeks and proportionately full top and bottom halves of our face. Collagen acts as an anchor holding all three layers of skin not only together but adhered to our underlying tissue and bone structure so our skin doesn’t sag and we have a defined profile and lines.


Collagen works closely with the protein elastin which, as its name suggests, is responsible for our skin and organs having elasticity or being flexible. We can make expressions, tug and pinch our skin when we’re young and we don’t form any wrinkles. This is because we have the strong foundation of collagen that our outer layer of skin is holding onto and we have so much elastin that our skin just snaps back to place.

Elastin works with collagen in the middle layer of our skin to form a protective barrier around those deeper fat pads, keeping them in place. When we smile, the fat pads move, but they go back to their original position because we have collagen and elastin working together to keep everything in place.

Hyaluronic Acid

The third youthful appearance powerhouse is this naturally produced sugar. Each molecule of hyaluronic acid holds up to 1000 times its weight in water. It’s hyaluronic acid that makes young skin look dewy and supple all the time. This sugar keeps the skin, eyes and connective tissues lubricated and hydrated at all times. Because it’s able to hold so much water, these molecules actually attract moisture, not just hold on to it.

Hyaluronic acid works with collagen and elastin to help keep our skin wrinkle-free and glowing. When the skin is packed with moisture, there’s less of a chance it will appear wrinkled. Think of how your hands can look when they’re very dry and the difference that putting lotion on them makes. This is the continuous effect hyaluronic acid has on young skin.

What Happens?

That all sounds great, right? Well, around the time we turn 20, we start to lose production of all these great proteins and sugars at a rate of about 1% per year. Because we have more collagen, we notice the impact of its decline more than any other.

The Loss of Collagen

When we lose production of collagen, that really strong foundation we had under the surface of our skin starts to show weaknesses. On the surface, those weaknesses look like small wrinkles. Underneath our collagen fibroblasts are becoming sparser. This means that when we make expressions, our collagen fibers get moved to the side to make way for our flexing muscles and tissue.

Over time, crevices form in the dermis and gravity causes our skin to fall to fill those crevices causing wrinkles and folds. They will continue to get deeper and more severe the more collagen we lose each year.

The Loss of Elastin

It’s a double whammy to be losing both the strong collagen foundation of our skin and the flexibility elastin provided. Now, after repeated flexing with expressions and facial movements plus the constant pull of gravity, our skin can’t bounce back into place.

This gets worse as the years, go by and wrinkles and lines can get deeper and longer as more skin loses its ability to bounce back. This is also when we start to lose the war with gravity and our skin sags in areas. We notice this most around our eyebrows, chin, jowls and neck, though it can happen in places of volume loss too, like the cheek area.

The Loss of Hyaluronic Acid

You’ve probably noticed more and more facial products have hyaluronic acid as their primary ingredient because of how amazing it is in keeping our skin hydrated. When we lose hyaluronic acid production, our skin can take on a crepey look and feel, showing each pore and every fine line.

Losing this sugar also reduces the hydration in the tissues farther below the surface of our skin. This can contribute to our faces looking sunken and hollow as those fat pads deep below the surface lose their shape and position.


As bleak as this may all sound, dermatology and cosmetic medicine has come a long way and has plenty of solutions for any of these issues. The most common concern we hear is wanting to get rid of lines, wrinkles and folds. There are several great options in the dermal filler family. Many of them are made of hyaluronic acid, which gives clients natural-looking results, but once the product is safely absorbed by the body, it’s time to get re-treated.

There is a dermal filler that gets your body to actually produce more collagen. When this happens, that foundation that used to keep our skin so smooth and wrinkle free rebuilds to smooth existing wrinkles. The treatment that provides these kinds of spectacular results is Radiesse.

What Is Radiesse?

Radiesse is an injectable in the dermal filler family. But this treatment has an entirely different active ingredient than others, which is why the body reacts so differently. Radiesse is made from calcium hydroxyapatite microspheres suspended in a water-based gel. These microspheres are made from hydrogen, oxygen and carbon and mimic connective tissue.

How Does Radiesse Eliminate Wrinkles?

The microspheres of this treatment create a scaffold, much like collagen used to make under the surface of your skin. As the microspheres settle under your skin, collagen fibroblasts grow, surrounding the microspheres. This works on wrinkles in two ways. The first is the immediate plumping of the tissue under the wrinkle. The water-based gel works like any other filler, plumping up the area under the wrinkles, making them effectively disappear.

The second is that once the gel dissipates, collagen has already started growing. This continues to keep wrinkles at bay because the foundation that was riddled with the crevices our skin fell into forming those wrinkles is smoothing out again. The results from this treatment last longer than other dermal fillers.

Treatment Areas

Think of the nasolabial folds that run from the nose to the corners of the mouth. Those are typically the deepest wrinkles we have on our faces. When this treatment is injected, collagen underneath those folds grows thicker and more tightly packed like it used to be. If you smile after treatment, it’s that strong foundation that won’t let your skin fall into a crevice, not a filler product.

Other areas that can be treated with Radiesse are:

  • Marionette lines from the corners of the mouth to the chin
  • Pre-jowl folds where volume loss causes the skin to sag
  • Down-turned corners of the mouth
  • Chin wrinkles or dimples that distract from your smile
  • Lost areas of volume affecting the cheeks and cheekbones
  • Lost areas of volume affecting the temporal area
  • Lost volume on the backs of the hands

What to Expect

We always have an in-depth consultation with each client to determine the right treatment for them. We’ll talk through areas of concern and examine the skin at and around the area. We’ll discuss your expectations of results. Once we understand your concerns, we’ll make a recommendation and explain the benefits of treatment. If we decide Radiesse is the right treatment for you, we’ll give you just a few pre-treatment instructions.

We just ask that you avoid any harsh facial treatments for a week or two before your appointment. We want to have a clear idea of where your loss of volume is, and that can be difficult to do with some post-treatment swelling from things like micro-needling and chemical peels. Also, to reduce the risk of bruising, it’s a good idea to stop taking blood-thinning medications and supplements for two weeks. These include products like:

  • Aspirin
  • Fish Oil
  • Ibuprofen
  • High dose vitamin E
  • Naproxen Sodium
  • Gingko Biloba
  • Ginseng

Your Appointment

On the day of your appointment, we may apply a small amount of numbing cream to the area to be injected just to ensure you’re completely comfortable. Once the area is numb, we’ll make a series of injections to address your areas of concern. When we’re finished with treatment, you’re free to go back to work or your normal social routine. There is no downtime associated with this treatment.

Many of our clients will make this appointment for a break from work and go immediately back to the office from our clinic.


You’ll see an immediate improvement in the appearance of wrinkles. Unlike other fillers where the best results really are the day of treatment, you may see an improvement in your results over the next few weeks as your body produces collagen underneath the surface of your skin. This will only work to fill in lines and wrinkles even more.

Results from this treatment last longer than most fillers. You can expect results to last from 12 to 18 months, though many clients report seeing results last closer to the two-year mark. Results vary between clients and can depend on many factors.

Address Your Wrinkles and Lines

You don’t have to live with the unwelcome signs of aging and the toll it takes on your self-confidence. Grossman Dermatology. We are committed to helping our clients look and feel their absolute best by helping them reach all their aesthetic goals. Dr. Grossman believes in helping you be the most beautiful version of you!

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