BACKGROUND: The use of calcium hydroxylapatite (Radiesse®, BioForm Medical, San Mateo, California) for cosmetic soft tissue augmentation has increased significantly in recent years.  Only a handful of authors have reported patient satisfaction data. 

METHODS:  A meta-analysis of published data was performed using a five-point scale for patient satisfaction to allow data comparison across studies.  A patient-centric outcomes study was performed at our institution using a questionnaire.  

RESULTS:  Five usable studies were identified for meta-analysis.  Patient satisfaction was 4.16 out of 5 in 324 patients at 3-6 months and 4.15 in 86 patients at one year.  In our institutional patient-centric outcomes study, the early satisfaction rate was 3.7 out of 5.  At one year the rate was only 2.3 out of 5. 

CONCLUSION:  Calcium hyroxylapatite remains a viable option for augmentation of facial soft tissue structures.  However, this report shows that further, accurate, large population outcomes assessments are absolutely required.