Formulation / mechanism / evidence
HA, CaHA and PLLA.
Understand the distinction.
A comparison of three named examples. Their formulations illustrate material differences; the findings do not represent every product within each class.
Material comparison · No head-to-head ranking or universal duration claim
| Question | Juvéderm Voluma XC HA · US source scope | Radiesse CaHA · US source scope | Sculptra PLLA · US source scope |
|---|---|---|---|
| Material & formulation | The original FDA label specifies crosslinked HA at 20 mg/mL and 0.3% lidocaine. The document is dated October 2013.[1] | Synthetic CaHA particles in a carrier containing water, glycerin and sodium carboxymethylcellulose. The US IFU describes 25–45 μm particles.[1] | An implant containing PLLA microparticles, sodium carboxymethylcellulose and mannitol, supplied as a dry formulation for reconstitution.[1] |
| Mechanism | A viscoelastic HA gel provides physical tissue augmentation; material and tissue interaction influence the result.[1] | The implant provides tissue augmentation. Human biopsy research also reports collagen and elastin remodeling, a biological endpoint distinct from visible benefit.[1][2] | PLLA is used for progressive tissue correction. The appearance immediately after reconstitution and injection should not be equated with the eventual result.[1] |
| Source-market indications | Current US manufacturer information lists cheek volume loss, chin augmentation and moderate-to-severe temple hollowing in adults over 21. The original label covers cheeks only.[1][2] | The linked US IFU covers facial folds, HIV-associated facial lipoatrophy and a specified diluted décolleté application in adults 22 and older. Hand treatment has a separate IFU.[1] | US labeling covers nasolabial contour deficiencies and facial wrinkles, including cheek lines, in immune-competent people. HIV lipoatrophy has its own instructions.[1] |
| What duration evidence measures | A midface study reported patient-rated improvement in 79% at two years. This is not a guarantee for every patient or another anatomical site.[1] | Biopsies at four and nine months demonstrate a tissue response in the studied population; they do not measure universal cosmetic duration.[1] | The randomized cheek-wrinkle trial assessed response at month 12. Its endpoint and treatment course should accompany any duration claim.[1] |
| Contraindications | Severe allergies, relevant bacterial-protein sensitivity and lidocaine allergy are contraindications. Defer treatment at sites with active inflammation or infection.[1] | Severe allergies, component hypersensitivity and bleeding disorders are contraindications. Defer active infection or inflammation.[1] | Component hypersensitivity and susceptibility to keloid or hypertrophic scar formation require exclusion under the IFU. Assess inflammation, infection and immune status.[1] |
| Safety considerations | Tenderness, swelling, bruising and nodules are reported. Intravascular injection can cause necrosis, visual loss or stroke.[1][2] | Bruising, pain, swelling and nodules are possible. Intravascular placement can cause ischemia, necrosis, blindness or stroke.[1] | Local reactions, papules and delayed nodules can occur. Avoid intravascular placement; superficial implantation increases local complication risk.[1] |
Read across the columns carefully.
Each study has its own population, treatment course, comparator and assessment method. The small CaHA-versus-HA biopsy study examines histology; the Sculptra cheek study examines wrinkle response; VOLUMA follow-up includes patient ratings. These endpoints do not create a comparative effectiveness ranking.