DCLASSY · Radiesse in Daegu — who is a CaHA collagen booster right for?
CaHA (calcium hydroxylapatite) sits among the collagen boosters with stronger regulatory approval and clinical evidence, and it is at the same time a material that cannot be dissolved out once it is in. Both statements come from the same property. So before who it suits, we set out whom we do not recommend it for.
The short answer
We consider DCLASSY and Radiesse (CaHA) first when, on top of thinning skin, firmness has dropped and the cheeks or temples have gently hollowed. Right after injection the gel provides volume; once the gel is absorbed, the remaining microspheres stimulate collagen formation. There is no agent that dissolves CaHA, so the rule is not to treat the lips or under the eyes and not to overcorrect. Most of the clinical evidence concerns Radiesse, and we could not find any published clinical study of DCLASSY itself.
What does CaHA do inside the skin?
CaHA is a material of the same mineral family as bone and tooth, formed into microscopic spheres and mixed into a gel. Its action unfolds in stages.
- Same dayThe gel fills spaceAn immediate change similar to a filler. Looking slightly overdone, mixed with swelling, is normal.
- 1–2 monthsThe gel is absorbedThe initial fullness fades, and it is easy to feel “the effect has gone”. In fact this is when the real mechanism begins.
- 3–6 monthsCollagen around the microspheresBiopsies have shown type III, then type I collagen and elastin increasing. Progress is judged around this time.
- 1–2 yearsMicrospheres break downReported as 12–30 months depending on the study, a wide range with large individual variation.
Exactly which pathway drives this process has not been fully established, and reviews on the subject also state that the evidence is not yet sufficient.
DCLASSY and Radiesse: what is the same and what differs?
| Item | Radiesse | DCLASSY |
|---|---|---|
| Manufacture · supply | Merz Aesthetics (Germany) | Manufactured by CGBio · supplied by DNC Aesthetics (South Korea) |
| Korean approval | 2010, tissue-repair material — temporary improvement of facial wrinkles; temporary restoration of dorsal hand volume (2017) | Tissue-repair material — temporary improvement of facial wrinkles |
| Published specifications | Microspheres 25–45 μm, 30% of total weight | Presentations 0.8 mL · 1.5 mL |
| Human clinical data | Many trials behind FDA approvals | No published clinical study of the product itself found |
Approvals abroad are not the same as approval in Korea. The US FDA has approved CaHA for facial wrinkles (2006), the back of the hand (2015), jawline contour (2022) and the décolleté (2026, a 152-person, 84-week multicentre randomised trial). Of these, jawline contour and the décolleté are outside the Korean approval. Nor do we transfer Radiesse’s clinical results to DCLASSY.
No published data compare the two products directly. Miso Clinic keeps both not because one outranks the other, but to have options by area and purpose.
It cannot be reversed — starting with the areas we avoid
Hyaluronic acid fillers can be dissolved with hyaluronidase, but there is no such agent for CaHA. The management of a nodule — saline injection and massage, intralesional injection, laser and, as a last resort, surgical removal — disperses or removes the material rather than dissolving it. In a review of 5,081 treatments, nodules were also the most common adverse event.
- Lips · under the eyes (tear trough) — areas prone to nodules, so we do not treat them
- Precise contour sculpting — poorly suited to fine adjustment; HA filler fits better
- Melasma · redness · pores · acne scars — not indications for CaHA
- Expression lines — the territory of botulinum toxin
- Pregnancy or breastfeeding, under 18, bleeding disorders, autoimmune or granulomatous disease — we do not treat, or discuss first
CaHA shows up clearly on CT. If you have facial imaging, tell the medical staff about the treatment so that it is not mistaken for a lesion.
Concerns CaHA suits, and concerns another class suits
| Concern | Judgement | Why |
|---|---|---|
| Loss of firmness + gentle hollowing of cheeks or temples | CaHA first | Immediate volume and collagen stimulation together |
| Several skin booster sessions, but not enough change in firmness | Consider CaHA | Particles remain and act more strongly in place |
| Rough texture and thinning skin are the main problem | GOURI · Rejuran · hADM first | Spread widely without particles, or address the environment or material |
| Areas such as the neck or back of the hand where volume must not be added | Discuss diluted CaHA | Dilution is not watering down but a layout that reaches more cells — no study compares dilutions |
| Jawline sagging with a collapsed contour | Lifting devices first | Injections do not lift |
A 2024 systematic review of CaHA studies (13 controlled studies, 1,171 subjects) noted that risk of bias in design and heterogeneity between studies make pooled analysis difficult. Collagen increase at the level of the material is relatively well supported, but it is not yet at the stage of promising any individual product’s performance in numbers.
Summary
What is established
- CaHA = immediate volume (gel) → gel absorbed → collagen around microspheres — microspheres break down over one to two years
- Radiesse FDA approvals: face 2006 · back of hand 2015 · jawline 2022 · décolleté 2026 (in Korea, face and back of hand only)
- No agent dissolves CaHA — the most common adverse event is nodules
What we could not find
- A published clinical trial of DCLASSY itself
- A direct comparison of DCLASSY and Radiesse
- A human study comparing results between dilutions (1:2 · 1:4 · 1:6)
DCLASSY and Radiesse in Daegu: frequently asked questions
Is it true that DCLASSY and Radiesse cannot be dissolved?
Yes. Hyaluronidase does not act on CaHA, and no agent breaks CaHA down. If a problem arises there are stepwise methods such as saline injection, intralesional injection, laser and surgical removal, and the microspheres themselves break down over one to two years.
It has been about a month and the effect seems to have gone.
That is usually the normal course. The gel that created the initial volume is absorbed over one to two months, so the full feeling fades; the collagen change accumulates after that and becomes clear at three to six months.
Which is better, DCLASSY or Radiesse?
No published data compare the two products directly, so there is no basis for ranking them. Most of the clinical evidence concerns Radiesse, and Miso Clinic chooses according to area and purpose.
Can CaHA be used under the eyes?
Miso Clinic does not use CaHA under the eyes (tear trough) or in the lips. These areas are prone to nodules and CaHA cannot be dissolved to reverse it. We approach the under-eye area by other means.
How long does CaHA last?
The microspheres break down over one to two years, reported as 12–30 months depending on the study, a wide range. Individual variation and differences by area and amount are large, so it is hard to give a single figure.
Can I have Radiesse for jawline lifting?
The US FDA approved CaHA for jawline contour in 2022, but that is outside the Korean approval. If jawline sagging is the main problem, Miso Clinic considers lifting devices first.
Read next
Product pages
Each product is covered in the DCLASSY reference · Radiesse reference.
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, medical director of Miso Clinic in Daegu, South Korea. Every study cited above is given together with its design, its size and the limitations the authors themselves recorded, and where we could not find data, we have said that we could not find any.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- CaHA approvals in Korea — Radiesse: MFDS approval 2010; indications temporary improvement of facial wrinkles · temporary restoration of dorsal hand volume (2017); microspheres 25–45 μm · 30% of total weight (Merz). DCLASSY: manufactured by CGBio · supplied by DNC Aesthetics; tissue-repair material; indication temporary improvement of facial wrinkles; presentations 0.8 mL · 1.5 mL. We could not find any published clinical study of DCLASSY itself.
- CaHA approvals abroad — US FDA, Radiesse Summary of Safety and Effectiveness Data (P050052 and subsequent supplements). Facial wrinkles 2006 · dorsal hand 2015 · jawline contour 2022 · décolleté 2026 (152 subjects · 84-week multicentre randomised trial). Jawline and décolleté are outside the Korean approval.
- CaHA systematic review — Journal of Clinical Medicine 2024. 13 controlled studies · 1,171 subjects; notes that risk of bias in design and heterogeneity between studies make pooled analysis difficult.
- CaHA safety — Safety of Calcium Hydroxylapatite: A Review (2017), analysis of adverse events across 5,081 treatments — nodules were the most common. Management of Nodules Following CaHA Injection, Aesthetic Surgery Journal 2024 — stepwise management. No agent exists that dissolves CaHA.
- CaHA dilution — 2017 neck and décolleté study, 20 subjects, dilution of 1:2, 1:4 or 1:6 assigned by skin thickness; biopsies at baseline, 4 and 7 months showed increased type I collagen. Not a study comparing dilutions with each other.
- Miso Clinic clinical protocols — criteria for indications, design by area, and the explanation and consent process before treatment. The source of the sentences marked “clinical judgement” in this column.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.