We are Dr. Caroline Warden and Louise Devereux — two sisters running a family-run aesthetic clinic in Hale, Cheshire / South Manchester. We specialise in natural but noticeable-looking results and use evidence-based treatments with FDA/MHRA approved products.

What are Dr Caroline Warden’s qualifications?

Dr Caroline Warden has been an NHS doctor for over 18 years and a practising GP for the past 9 years. She holds a postgraduate Level 7 diploma in cosmetic injectables from the Harley Academy in London.

What treatments do you offer?

Services include anti-wrinkle injections, skin boosters (e.g. Profhilo), superficial and medium-depth chemical peels, dermal fillers (cheeks, lips, chin, jawline), regenerative medicine (polynucleotide and exosome treatments), microneedling with exosomes, lip booster injections, and medical-grade Obagi skincare.

How much are the treatments?

Treatment prices are available on request or via the dedicated price list; there is also a separate skincare price list.

I’m keen to get some advice / a treatment — what’s the process?

You complete medical and skin questionnaires first, then have a thorough consultation where Dr Caroline assesses your skin and formulates a personalised treatment plan. If medically suitable and time permits, same-day treatments can be performed. The consultation costs £50 and is fully redeemable against any future treatments (excluding skincare products).

How do I book an appointment?

You can book directly using the booking link on the website, fill in the contact form, or message via Instagram/Facebook. Alternatively, you can email drcarolinewarden@gmail.com.

How do I cancel or reschedule?

You can cancel or reschedule via your Glowday login. Cancellations within 48 hours incur a £25 fee; no-shows incur a £50 fee. Multiple short-notice reschedules may result in being unable to rebook.

Where are you located?

Our clinic is located at 2 Crown Passage, Hale, WA15 9GN, in the heart of Hale, South Manchester / Cheshire.

What should I do when I arrive?

Just come in the front door and take a seat in the reception area. We’ll send a contact number 24 hours before your appointment so you can reach us if there are any issues.

Will my treatment hurt?

We use ultra-fine needles and dermal fillers with local anaesthetic. We also offer distraction tools like vibration wands, fans, stress balls, cryo-balls, and strong numbing creams. Louise is often present to offer extra comfort and support.

You can pay by cash or card. There is a cash machine two minutes’ walk from the clinic at the Co-op on Altrincham Road. A pre-payment plan is not currently available, but is planned for the future.

What if there is a complication?

After every appointment you receive detailed aftercare instructions and Dr Warden’s personal mobile number. If there is a complication, advice and treatment post-procedure will be provided free of charge.

What if I don’t like the results?

Results cannot be guaranteed and refunds are not offered if you are unhappy. Treatments will eventually wear off naturally. If a dermal filler complication arises, dissolving is offered for free; dissolving for other reasons is available for a fee.

How long does Hyperdilute Radiesse last?

The product itself is biodegradable and is broken down within months. What persists is the collagen and tissue remodelling it stimulates. Studies have shown improvement maintained at twelve months in the hands and the decolletage. In practice, I suggest reviewing at around six months and considering maintenance at around a year.

How often will I need maintenance?

Approximately once a year is a useful guide after the initial course, although maintenance is assessed individually rather than run to a fixed schedule.

Does the treatment hurt?

There can be some discomfort during treatment. Radiesse+ contains lidocaine and the hyperdilution process also includes local anaesthetic, which improves comfort considerably.

Will I look swollen afterwards?

Swelling can occur, particularly on the hands and larger body treatment areas. Bruising and tenderness are also possible. This is generally temporary and settles over several days.

What are the side effects of Hyperdilute Radiesse?

Common temporary effects are swelling, bruising, tenderness, redness and occasionally temporary lumpiness. Less common complications include infection, inflammatory reactions and nodules. Vascular compromise is a rare but serious complication of any injectable treatment.

Can Hyperdilute Radiesse treat loose skin after weight loss?

It may improve mild crepiness and skin laxity, but it cannot remove significant excess skin following major weight loss.

Can Hyperdilute Radiesse be used on the abdomen after pregnancy?

In appropriately selected patients it may be considered for mild abdominal skin laxity or crepiness once pregnancy and breastfeeding have finished. Significant muscle separation or excess skin requires a different assessment and may ultimately be better addressed surgically.

Can I have Hyperdilute Radiesse on my neck?

Yes. The neck is one of the best-studied hyperdilute calcium hydroxylapatite treatment areas and one of the areas I most commonly treat.

Can I have my neck and decolletage treated together?

Yes, and they are commonly treated together as part of the same skin quality plan. They generally require one syringe for each area.

How much does Hyperdilute Radiesse cost?

From 450 GBP per syringe or treatment area. Neck, decolletage or both hands are usually one syringe at 450 GBP. Abdomen or above both knees usually require two syringes at 795 GBP. A consultation fee of 75 GBP applies for new patients, redeemable against treatment on the day.

Hyperdilute Radiesse® Hale & Altrincham | Neck & Body Skin — Dr. Caroline Warden Skin & Aesthetic Clinic

Firmer, smoother skin where filler was never the answer

There are parts of the body where you can look after your skin carefully for years and still watch it change. The neck goes crepey. The décolletage develops fine lines. The backs of the hands look thinner and more depleted. Skin above the knees loosens, and the abdomen changes after pregnancy, weight loss or simply time. None of these areas needs filler. What has changed is the quality and support of the skin itself, and that needs a different tool.

Hyperdilute Radiesse is that tool. Radiesse is a calcium hydroxylapatite biostimulator; diluted and placed just beneath the skin, it stops creating volume and starts doing what I actually want on the neck or chest: encouraging the skin to rebuild its own collagen and elastin, so that over the following months it becomes firmer, smoother and more resilient without looking filled.

I am Dr Caroline Warden, an NHS GP with over nineteen years of clinical experience, an independent prescriber and a Level 7 qualified aesthetic doctor trained at Harley Academy. I introduced hyperdilute Radiesse to my clinic in Hale, near Altrincham, only once I had satisfied myself that the evidence was real, and I set out below where it is strong and where it is thinner. Every consultation, treatment and review is carried out by me personally.

Good to know

Two treatments six to eight weeks apart, then maintenance roughly once a year. Thirty to forty-five minutes, with local anaesthetic in the dilution. Swelling and possible bruising for several days, most noticeable on the hands. Firmness builds over three to six months. £450 per area; neck and décolletage together include Obagi ELASTIderm Neck and Décolleté Concentrate.

On this page:

An important note on licensed use
What is hyperdilute Radiesse and how does it work?
Where can it be used?
What the evidence shows, area by area
How it compares with Profhilo, Sculptra and microneedling
What to expect at your appointment
Results, course and how long they last
Safety and suitability
Prices
Frequently asked questions

An important note on licensed use

Radiesse is licensed in the UK for specific indications. Its use in hyperdiluted form, and across several of the body areas on this page, falls outside those standard licensed indications. This is a common, well-established practice in aesthetic medicine, supported by a growing published evidence base, and entirely lawful for a qualified doctor. It is also something you should know before treatment, not after. Where it applies to you, I explain it at consultation and it forms part of your written consent. If you would prefer a treatment used strictly within its licence, I will tell you what the alternatives are.

Two women sitting on a bed in a room with beige walls, one holding a tablet and the other looking at it.

What is hyperdilute Radiesse and how does it work?

Radiesse is made of microscopic particles of calcium hydroxylapatite (CaHA), a mineral the body already contains, suspended in a gel carrier. Used neat, it provides structure and contour in the face. Diluted with saline and local anaesthetic, its behaviour changes: the immediate volumising effect largely disappears, the product spreads evenly across a much wider area of tissue, and the emphasis shifts to biostimulation.

Skin ageing is not only wrinkles. Four connected things change: collagen, the framework that gives skin strength and thickness; elastin, the fibres that let it stretch and recoil; dermal thickness, which falls progressively; and the extracellular matrix, the environment around skin cells, which degrades. Hyperdilute CaHA acts as a scaffold within that tissue. As the carrier gel is absorbed, the microspheres interact with fibroblasts and stimulate remodelling of the matrix, with new collagen and elastin laid down around them. The particles are then broken down and cleared. What matters clinically is not the product but the tissue response it leaves behind, which is why this is fundamentally different from placing volume under loose skin.

The global consensus guidelines on diluted CaHA, published in Dermatologic Surgery in 2018, describe it as

"very effective for skin tightening of the neck and décolletage"
Goldie K et al., Dermatologic Surgery, 2018

Dr Caroline's note

I turned down body skin treatments for a long time, because most of them promised more than the evidence supported. What changed my mind about hyperdilute Radiesse was the quality of the trial data for the hands and the décolletage and a credible biological mechanism behind it. I wrote about the three questions I needed answered first in why I'm introducing hyperdilute Radiesse to my clinic.

Where can hyperdilute Radiesse be used?

Area	What it improves	What it cannot do
Neck	Crepiness, horizontal lines, early laxity, thin skin; my most common area. See the neck and décolletage guide	Remove significant loose skin or reproduce a surgical neck lift
Décolletage	Fine vertical and criss-cross lines, crepey texture, thinning from years of sun	Fix pigmentation, which needs skincare
Backs of the hands	Thin, depleted skin with visible veins and tendons; the area closest to the licensed indication. See the ageing hands guide	Remove sun spots
Abdomen	Mild crepiness or laxity after pregnancy, weight loss or ageing, without a large amount of excess skin	Replace an abdominoplasty where there is substantial loose skin or muscle separation
Above the knees	Thin, wrinkled or crepey skin above the kneecap; a common concern that few treatments address	Remove excess tissue

I use it where the problem is early to moderate deterioration in skin quality, not significant excess skin. Where excess skin is the issue, no injectable will do what surgery does, and I will tell you so.

What the evidence shows, area by area

The evidence is not equally strong for every area, and I would rather say so plainly than present all five as though they carried the same weight.

Area	Strength of evidence	What has been shown
Hands	Strongest: randomised, blinded, multicentre trial	114 patients; 98% reported improvement at three months and 86% at twelve; no effect on hand function
Décolletage	Strong: randomised, evaluator-blinded, multicentre	73.5% improved by at least one grade in resting chest wrinkles at 16 weeks after the final treatment, with safety followed across 52 weeks; earlier prospective work showed improvement still measurable at twelve months
Neck	Moderate: small uncontrolled studies	In 22 women after two treatments, 82% improved in laxity and 86% in horizontal lines; dermal thickness up about 15% at day 120; 91% judged improved
Above the knees	Limited: one small pilot study	Significant improvement in laxity and cellulite appearance at three months; all patients satisfied; temporary swelling and irregularity reported
Abdomen and upper arms	Limited: small published case series	Improvement in mild skin laxity and tightening

Taken together, that is randomised controlled data for the hands, randomised evaluator-blinded data for the décolletage, neck studies showing improvement in laxity, lines and dermal thickness, and published work on the body. It gives us a well-reasoned answer to a question patients ask me more and more: how do we improve ageing skin without adding more filler?

How it compares with Profhilo, Sculptra and microneedling

Treatment	What it is	Best suited to
Hyperdilute Radiesse	Diluted calcium hydroxylapatite; deep-tissue collagen and elastin stimulation	Crepiness, reduced firmness, mild laxity and thinning skin on the neck and body
Profhilo	Hyaluronic acid bioremodelling	Hydration, dullness and early laxity; see the skin boosters page
Sculptra	Poly-L-lactic acid collagen stimulator	Gradual, global collagen restoration and facial structure; see the Sculptra page
Medical microneedling	Controlled superficial injury and repair	Texture, pores, fine superficial lines and scarring; see the microneedling page

Profhilo hydrates; hyperdilute Radiesse has the stronger emphasis on collagen and elastin, so for a crepey, softening neck it is usually my choice, and for a dry, dull one Profhilo may suit better. Sculptra and structural Radiesse are for facial volume; hyperdilute Radiesse is for skin across the neck and body. Microneedling works at the surface, hyperdilute Radiesse in the deeper tissue, and some patients have both at different stages. Combinations are chosen because they address different problems, never because they are available.

The goal is better skin, not a bigger treatment area. That is exactly why it works on the neck, chest, abdomen and knees, where added volume would be the last thing anyone wants.

Exterior view of Dr. Caroline Warden Aesthetic Clinic, showing a brick wall with a gray sign indicating the clinic's name, and large glass entrance doors with a reflection of trees and a lit interior.

What to expect at your appointment

Stage	What happens
1. Consultation	I assess the skin quality, the degree of crepiness against true laxity, the amount of excess skin, your anatomy, medical history and previous treatments, and what improvement is realistic. The licensed-use position is explained and forms part of your consent. Before photographs are taken
2. Preparation	The product is diluted at the time of treatment with saline and local anaesthetic; Radiesse (+) already contains lidocaine, so comfort is good
3. Treatment	Delivered with a cannula through a few small entry points, or a fine needle where the area suits it, spread evenly across the whole treatment area. Thirty to forty-five minutes depending on the area. Massage afterwards where I ask for it, because it matters for an even result
4. After	Written aftercare, my direct number, a check-in from me, and the second session booked six to eight weeks on. Review at around six months

Good to know

Expect swelling, and possibly redness or small bruises, settling over several days; swelling is most noticeable on the hands and larger body areas, so plan the hands clear of a wedding or a week of heavy typing. For 24 to 48 hours avoid strenuous exercise, saunas, steam rooms, sunbeds and very hot baths, and alcohol on the day. Then daily SPF on the treated area, particularly the décolletage and hands, which lose the improvement you have paid for faster than anywhere else if left unprotected.

Neck and décolletage: the combined skincare protocol

Injectable treatment is one part of improving skin quality. For the neck and décolletage I consider targeted home skincare part of the protocol, not an optional extra, because the injectable works on the deeper structural layers while the skincare works on the surface. Where neck and décolletage are treated together, the plan includes Obagi ELASTIderm Neck and Décolleté Concentrate, provided at your first session; where a single area is treated, the same product is available at half price alongside treatment.

I should be open that the clinic supplies Obagi skincare and therefore has a commercial interest in it. I recommend it because I use it and rate it, and you are free to decline it or to use an equivalent of your own.

A cozy sitting area with four beige cushioned armchairs with wooden legs and arms, arranged around a small round wooden side table. The background features built-in wall shelves decorated with books, small sculptures, vases, plants, and a spiral shell. There is a window or glass door on the left, and a plant with white flowers on the right.

Results, course and how long they last

Hyperdilute Radiesse is not an overnight treatment. Some patients notice firmer texture early, but the meaningful change happens as collagen and tissue remodelling develop, and I ask you to think in weeks and months rather than days. For most patients I recommend an initial course of two treatments six to eight weeks apart; for more established crepiness or laxity a third may occasionally be appropriate. After that, roughly one maintenance treatment a year, decided by looking at your skin rather than the calendar.

When	What you will notice
Days 1 to 7	Swelling, possibly bruising; a softening of veins and tendons on the hands from the carrier gel
Weeks 2 to 6	Early improvement in texture and firmness as remodelling begins
6 to 8 weeks	Second treatment
3 to 6 months	The clinically measurable result shown in the studies: thicker, smoother, firmer skin; review at six months
12 months	Improvement still present in 86% of hands patients and in the décolletage studies; consider maintenance

Dr Caroline's note

The patients I most often suggest this for say one of five things: "my neck suddenly looks crepey", "the skin above my knees bothers me more than my knees", "I've lost weight and the skin on my stomach looks thinner", "my hands look older than my face", or "I don't want filler, I just want my skin to look better". That last sentence describes hyperdilute Radiesse better than anything I could write.

Safety and suitability

Radiesse has a long history in aesthetic medicine and an extensive safety literature. Any injectable carries risk, and practitioner experience, anatomical knowledge and patient selection are what keep it low. Every patient has a consultation first, and I would rather you asked the difficult questions there than found the answers afterwards.

How often	What	How I keep the risk low
Expected and temporary	Swelling, bruising, tenderness, redness, temporary lumpiness or irregularity	Correct dilution, cannula, even distribution, massage where indicated
Less common	Infection, inflammatory reaction, nodules, persistent irregularity	Sterile technique, correct plane, conservative volumes, review at each visit
Rare but serious	Vascular compromise	Anatomical knowledge, cannula, low pressure, prompt recognition, emergency medicines on site

Treatment is not suitable where there is significant excess or hanging skin, severe laxity needing surgical correction, active infection or inflammation in the area, pregnancy or breastfeeding, or certain medical conditions identified at consultation. I will also occasionally advise against it simply because I do not think the likely improvement justifies the cost or the procedure. That is part of a medical consultation.

Prices

Treatment is priced at £450 per syringe or treatment area. The exact quantity is assessed individually before treatment.

Treatment area	Typical requirement	Price per session
Neck	1 syringe	£450
Décolletage	1 syringe	£450
Both hands	1 syringe	£450
Abdomen	2 syringes	£795
Above both knees	2 syringes	£795
New-patient consultation	£75	Redeemed against treatment on the day

Two sessions are usually needed, six to eight weeks apart. Neck and décolletage treated together include the Obagi ELASTIderm Neck and Décolleté Concentrate at the first session. Current prices are on the price list.

Book a hyperdilute Radiesse consultation

Frequently asked questions

Is hyperdilute Radiesse a filler?

Radiesse can be used as a structural injectable, but hyperdiluted its purpose is different: dilution removes most of the volumising effect and turns it into a biostimulator for skin quality.

Does hyperdilute Radiesse tighten skin?

Studies show improvement in laxity, firmness and wrinkles in the areas above. I describe that as firmer skin and improved mild laxity, not a surgical tightening effect.

Does it add volume?

No. That is the point of diluting it. The aim is better skin, not a bigger treatment area.

How long does it last?

The product is broken down within months; the collagen it stimulates persists. Improvement was maintained at twelve months in the hands and décolletage studies. I review at six months and consider maintenance at around a year.

How many sessions will I need?

Usually two, six to eight weeks apart; occasionally a third for more established laxity. Then roughly one a year.

Does it hurt?

Some discomfort is possible. Radiesse (+) contains lidocaine and more local anaesthetic is added in the dilution, which improves comfort considerably.

Will I be swollen?

Swelling is common, most noticeable on the hands and larger body areas, and settles over several days along with any bruising.

Can it treat loose skin after weight loss?

It can improve mild crepiness and laxity. It cannot remove significant excess skin; that is surgical.

Can it be used on the abdomen after pregnancy?

For mild laxity or crepiness once pregnancy and breastfeeding have finished, yes. Muscle separation or substantial excess skin needs a different assessment.

Can I have my neck and décolletage together?

Yes, and they usually are, one syringe each, with the ELASTIderm concentrate included.

Is it used within its licence?

Not in every area on this page. Hyperdiluted use and several body areas fall outside the standard licensed indications; this is explained at consultation and forms part of your written consent.

Is Radiesse permanent?

No. The microspheres are biodegradable and cleared by the body. The collagen and tissue remodelling they stimulate is what remains.

Hyperdilute Radiesse or Profhilo for the neck?

Crepey and softening: hyperdilute Radiesse. Dry and dull but still firm: Profhilo may suit better. The consultation decides.

Next steps

Book a consultation in Hale

Learn more about Dr Caroline Warden Clinic

Click here for price list

Learn more about other treatments offered

References

Goldie K, Peeters W, Alghoul M, et al. Global consensus guidelines for the injection of diluted and hyperdiluted calcium hydroxylapatite for skin tightening. Dermatol Surg. 2018;44 Suppl 1:S32-S41.
Goldman MP, Moradi A, Gold MH, et al. Calcium hydroxylapatite dermal filler for treatment of dorsal hand volume loss: results from a 12-month, multicenter, randomized, blinded trial. Dermatol Surg. 2018;44(1):75-83.
Pavicic T, et al. A prospective, multicenter, evaluator-blinded, randomized study of diluted calcium hydroxylapatite to treat décolleté wrinkles. J Drugs Dermatol. 2024.
Fabi S, Moradi A, Hill D, et al. Diluted calcium hydroxylapatite carboxymethylcellulose (Radiesse) for décolleté wrinkles: safety and effectiveness in adult females. Aesthet Surg J. 2026.
Fabi SG, Alhaddad M, Boen M, Goldman MP. Prospective clinical trial evaluating the long-term safety and efficacy of calcium hydroxylapatite for chest rejuvenation. Dermatol Surg. 2021.
Muniz M, et al. Efficacy and tolerability of hyperdiluted calcium hydroxylapatite (Radiesse) for neck rejuvenation: clinical and ultrasonographic assessment. Clin Cosmet Investig Dermatol. 2023.
Guida S, et al. Hyperdiluted calcium hydroxylapatite for the treatment of skin laxity of the neck. Dermatol Ther. 2021.
Guida S, et al. Hyperdiluted calcium hydroxylapatite for skin laxity and cellulite of the skin above the knee: a pilot study. Dermatol Ther. 2020.
Lapatina NG, Pavlenko T. Diluted calcium hydroxylapatite for skin tightening of the upper arms and abdomen. J Drugs Dermatol. 2017.
Bartoletti E, et al. Optimized calcium hydroxylapatite formulation and its injection technique for hand rejuvenation: a retrospective study. Dermatol Pract Concept. 2024.

Written and medically reviewed by Dr Caroline Warden, NHS GP with over 19 years of clinical experience, independent prescriber and Level 7 qualified aesthetic doctor (Harley Academy). GMC 6157708. Dr Caroline Warden Skin & Aesthetic Clinic, 2 Crown Passages, Hale, Altrincham, Cheshire WA15 9GN. Hyperdilute use of Radiesse is outside its standard licensed indications and is discussed and consented at consultation. Results vary between individuals. Last reviewed: 2 October 2026.

Hyperdilute Radiesse®

Doctor-Led treatments in Hale, Altrincham & Cheshire