Dr Ivan Puah Reveals That Using Calcium Hydroxyapatite

Dr Ivan Puah Reveals That Using Calcium Hydroxyapatite

February 2022

SINGAPORE, February 2022 — Calcium hydroxyapatite, also known as CaHA, in Radiesse®️ is the first and only FDA-approved filler available that provides both immediate and natural-looking results. Besides reversing volume loss in the face and hands, Radiesse®️ also stimulates collagen, the structural protein responsible for the youthful appearance in our skin.  

Radiesse®️ also acts as a biostimulatory agent for skin tightening on the face, neck and body when diluted with sterile saline and lidocaine. It can improve the mechanical properties of the skin and stimulate neocollagenesis and elastin formation over time. Several studies have demonstrated that injecting diluted forms of Radiesse®️, when combined with other treatment modalities, have proven to deliver visible, dramatic improvement to skin properties [3, 5, 7] in the face, neck and décolletage [1, 2, 4], buttocks, thighs [5], underarms [6, 8], abdomen [6], knees, and elbows. It is also effective in treating cellulite and striae [5]. 

Dr. Ivan Puah is an MOH-accredited liposuction and gynecomastia surgery doctor in Singapore and appointed trainer by Merz Aesthetics for fellow doctors on aesthetics injectables, such as Xeomin® (a uniquely purified neuromodulator), Belotero® (dermal fillers) and Radiesse® (a structural filler and biostimulator). With over 15 years of body contouring and liposuction experience, he has operated on many patients with excess body fat with pre-existing loose skin. Common causes  are genetically predisposed fat accumulation, rapid weight gain or loss over a short period, excess postpartum abdominal fat with stretched skin and even botched liposuction. 

Combination of MDC-Sculpt®️ Lipo technique and Radiesse filler for tighter skin

Dr. Puah has also co-conducted a study [8] on brachial laxity using the combination treatment of Ultherapy®️ and Radiesse®️, with results demonstrating significant improvements in objective and subjective measures of brachial skin laxity. Besides this, he has found that injecting diluted Radiesse®️ promotes successful and enhanced skin tightening for post-liposuction patients who have had their arms or abdomen treated. 

MDC-Sculpt®️ Lipo technique is a novel fat removal and body contouring technique that Dr. Ivan Puah has developed. This unique approach can effectively remove more than 90% of localised subcutaneous fat tissues, achieve precision sculpting, and induce collagen reproduction for firmer skin, which was previously not achievable with traditional liposuction.  

In theory and practice, liposuction is not a straightforward fat removal procedure. This is why Dr. Puah views surgical body sculpting as 30% science and 70% art, taking into account safely removing fat in bulk and creating a natural and aesthetically pleasing body form.   

“I have encountered patients who are worried whether removing fat will result in loose skin. The answer, in short, is no, IF the surgical approach is done right. MDC-Sculpt®️ Lipo technique stimulates skin tightening, and for those who want to achieve even better-enhanced skin retraction, Radiesse®️ injection in diluted form is my next line of treatment as it is safe, non-surgical and non-invasive,” says Dr. Ivan Puah. 

Radiesse®️ is suitable for patients with moderate skin laxity and is ideal for tackling the adverse effects of skin ageing such as sagging, loose folds, turkey neck and more. “Radiesse® injection in diluted form works as a bio-stimulating agent. It stimulates collagen and elastin production. Patients may require two treatments – the first session is done four weeks post-surgery, and the second one takes place one month later. Patients with flabby arms, abdominal skin laxity and crepe-like skin around the neck will greatly benefit from this combined treatment as it creates long-term skin tightening. In the past two years, many patients have benefited from the combined treatment of MDC-Sculpt®️ Lipo technique for body sculpting and hyper-diluted Radiesse®️ injection to reverse crepe-like skin,” Dr Ivan Puah shares. 

Body contouring results can now be fully optimised with medical technology and innovative surgical techniques and products. 



[1] de Almeida, A. T., Figueredo, V., da Cunha, A., Casabona, G., Costa de Faria, J. R., Alves, E. V., Sato, M., Branco, A., Guarnieri, C., & Palermo, E. (2019). Consensus Recommendations for the Use of Hyperdiluted Calcium Hydroxyapatite (Radiesse) as a Face and Body Biostimulatory Agent. Plastic and reconstructive surgery. Global open, 7(3), e2160. https://doi.org/10.1097/GOX.0000000000002160

[2] Casabona, G., & Nogueira Teixeira, D. (2018). Microfocused ultrasound in combination with diluted calcium hydroxylapatite for improving skin laxity and the appearance of lines in the neck and décolletage. Journal of Cosmetic Dermatology, 17(1), 66-72.

[3] Tatjana Pavicic, MD, PhD, Commentary on: Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice, Aesthetic Surgery Journal, Volume 42, Issue 1, January 2022, Pages NP38–NP40, https://doi.org/10.1093/asj/sjab331

[4] Yutskovskaya YA, Kogan EA. Improved Neocollagenesis and Skin Mechanical Properties After Injection of Diluted Calcium Hydroxylapatite in the Neck and Décolletage:A Pilot Study. Journal of Drugs in Dermatology : JDD. 2017 Jan;16(1):68-74. PMID: 28095536.

[5] Z Paul Lorenc, MD, FACS, Jeanette M Black, MD, Jessie S Cheung, MD, FAAD, Annie Chiu, MD, Roberta Del Campo, MD, Alan James Durkin, MD, MS, Miles Graivier, MD, FACS, Jeremy B Green, MD, FAAD, Gideon P Kwok, DO, Keith Marcus, MD, Charalambos “Babis” Rammos, MD, FACS, William Philip Werschler, MD, FAAD, FAACS, Skin Tightening With Hyperdilute CaHA: Dilution Practices and Practical Guidance for Clinical Practice, Aesthetic Surgery Journal, Volume 42, Issue 1, January 2022, Pages NP29–NP37, https://doi.org/10.1093/asj/sjab269

[6] Lapatina NG, Pavlenko T. Diluted Calcium Hydroxylapatite for Skin Tightening of the Upper Arms and Abdomen. Journal of Drugs in Dermatology : JDD. 2017 Sep;16(9):900-906. PMID: 28915285.

[7] Goldie, Kate MBChB*; Peeters, Wouter MD†; Alghoul, Mohammed MD, FACS‡; Butterwick, Kimberly MD§; Casabona, Gabriela MD║; Chao, Yates Yen Yu MD¶; Costa, Joana MD#; Eviatar, Joseph MD, FACS**; Fabi, Sabrina Guillen MD, FAAD, FAACS††; Lupo, Mary MD‡‡; Sattler, Gerhard MD§§; Waldorf, Heidi MD║║,¶¶; Yutskovskaya, Yana MD##; Lorenc, Paul MD*** Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening, Dermatologic Surgery: November 2018 – Volume 44 – Issue – p S32-S41 doi: 10.1097/DSS.0000000000001685

[8] Ramirez, Sylvia, and Ivan Boon Kwang Puah. “Effectiveness of combined microfocused ultrasound with visualization and subdermal calcium hydroxyapatite injections for the management of brachial skin laxity.” Journal of Cosmetic Dermatology 20, no. 12 (2021): 3871-3879.


Dr. Ivan Puah is the Medical Director of Amaris B. Clinic, a medical aesthetics, sculpting and fitness clinic in Singapore. He obtained his VASER® Body Sculpting training in Colorado and Argentina. He also received training and guidance in syringe liposculpture, fat grafting and thread lift by renowned French plastic surgeon, Dr. Pierre Francois Fournier, as well as dedicated surgical training in gynecomastia surgery in San Francisco. In Singapore, Dr. Ivan Puah is accredited by the Ministry of Health to perform liposuction and serves as the Chairman of Lipo Peer Review Committee in Singapore.

Dr. Ivan Puah holds a Graduate Diploma in Family Dermatology from NUS, a Graduate Diploma in Acupuncture from TCMB, and a Graduate Diploma in Sports Medicine from LKCMedicine, NTU. He is also the appointed trainer by Allergan and Merz for fellow doctors on Botulinum Toxin and Dermal Fillers. He is also the appointed training for N-Cog Thread and Picocare Laser from Venusys Medical in Singapore. 


Established in 2004, Amaris B. Clinic has been providing medical aesthetics and body sculpting services. Amaris B Clinic’s forte lies in body sculpting – surgically removing stubborn fat pockets to sculpt and shape different areas of the body through a variety and combination of services offered. Amaris B. Clinic received recognition as the “Body Sculpting Medical Centre of the Year (2021) in Asia Pacific”, “2020 Body Sculpting Medical Centre of the Year in the Asia Pacific”, “2020 Integrated Healthcare Medical Centre of the Year in the Asia Pacific” and “2019 Body Sculpting Provider of the Year in the Asia Pacific”, by GlobalHealth Asia Pacific. The clinic has also bagged the Best Innovative Treatments for Dr. Ivan Puah’s proprietary liposuction technique, VASER Lipo With MDC-sculpt® Lipo Technique from Daily Vanity’s Spa & Hair Awards 2021 and Honeycombers’ Love Local Awards 2021 – Editor’s Choice Winner: Best Aesthetics Clinic In Singapore.

The clinic’s signature treatments include:


Bianca Zen
Marketing Consultant
Amaris B. Clinic, www.amaris-b.com
140 Arab Street, Singapore 199827 
+65 6536 4211 | marketing@amaris-b.com 


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