Building up the cheek

Philip Young, MD answers: Cheek asymmetry after Radiesse lump removal

I had Radiesse injected on my right cheekbone to hide a small scar I had about three years ago. The Radiesse caused a lump to appear and seemed quite apparent which made me self-conscious. I wanted to make the lump disappear and I was going to have some steroids injected to help reduce the lump.

After hearing it was potentially dangerous, I decided to approach my GP, who forwarded me onto an NHS surgeon. The NHS surgeon cut around the initial scar, which was about 2 cm in length and about 3 mm in width running vertically on my cheekbone skin. He then scraped away the lump, which was a lump of tissue formed by the Radiesse.

Then he pulled the skin slightly closer and stitched it up to form a new, less noticeable scar. I feel a slight pulling sensation on that area from time to time. The new scar looks like a line. The lump was directly above my cheekbone, surrounded and probably entwined with the surrounding tissue. It seems as if the Radiesse formed its own collagen, which was the lump.

As the surgeon scraped the lump, it seems like he also reduced the top, curved part of my cheek bone (the right side) as well. Compared to my left cheek bone, the right cheek bone feels more flat.

I was wondering, is there any procedure that can imitate or restore tissue to build up the curve and definition of the cheekbone, as it doesn't look symmetrical and looks slightly flat?

Also, the surgery made my cheek area look swollen, and it still looks swollen a year after the lump removal. My GP said it may be scar tissue in the cheek. If it is indeed scar tissue, is there also any procedure that can identify the scar tissue inside the cheek and have it reduced?

Thank you!


Philip Young, MD
4 months ago
By Philip Young, MD - Seattle Facial Plastic Surgeon

This can be done with various fillers including restylane, juverderm, more radiesse, fat injections, or facial implants. Either of these options have benefits and drawbacks.  The fillers are temporary and you will need reaugmentation in 6 months to a year.  Facial implants will last essentially forever but need to be done in the exact way and augment your cheek in the best way.  When you place cheek implants into the cheek area, sometimes the cheek can be fixed on the cheek bone with metal screws and if there is less than ideal augmentation more or less then you can tailor the augmentation through different means. 

If you have too much augmentation, you can tailor the cheek implant with burrs if the cheek implant is solidly fixed with the screw.  If it is not big enough you can always place a bigger implant or  fix more silicone onto the existing implant with sutures. The key with silicone or other implants is to have the implant fixed so its stable, not moving and not collecting fluid between it and the bone.  These are things that can prevent infection and rejection. Silicone is probably the safest and most stable and non reactive implant that you can place.  Other implants create more inflammation and have a higher incidence of rejection and infection.

Fat injections are another way of building up the cheek.  The survival of fat is variable but if the fat survives after the first 6 months to a year the fat will likely survive for years.

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