Radiesse, Perlane, and Botox won't work

Peter A. Aldea, MD answers: Radiesse, Perlane, and Botox won't work

I had 2 Radiesse and 2 Perlane treatments three weeks apart. I paid total of $1800. I still have marked nasolabial folds, one longer than the other. Same with Botox; I paid for 3 injections and my glabella stills has the scowls lines after 4 weeks! Can you explain why these treatments won't work for me?


Peter A. Aldea, MD
3 months ago

Dear Patty,

Obviously, to give you a better answer we would have to look at good quality before and after the procedures pictures. But - in the absence of those, I have a few ideas on why treatments won't work.

1. Your condition may not have been easily correctable with fillers for the NL folds. MAYBE a Facelift was called for instead. At the risk of offending you, sometimes, to avoid losing patients SOME  doctors will do whatever the patient requests even though his/her judgment would have recommended something else. I an NOT saying that you pushed your doctor to do this, I am just going through the possibilities.

2. Not all doctors are created equal - some of us are better than others. You MAY have seen a doctor who MAY be wonderful with other procedures but whose talent with fillers and Botox MAY be limited. Again - I am NOT saying this was the case here.

3. Whenever I hear that Botox did not work the same set of questions comes up:
I. WHO did the injection and how anatomically knowledgeable were they?
II. was your Botox OVER-DILUTED? Happens all the time - you have no way of knowing just how many units you may have gotten.
III. How OLD was the Botox? Botox begins breaking down as soon as it is reconstituted. If your Botox was old, it was not as effective REGARDLESS of how many units you really received?
IV. Was YOUR Botox purchased through Allergan and shipped on dry ice to preserve its potency OR was it purchased from a "Canadian" pharmacy where one would NOT know HOW it was kept or shipped, potentially becoming deactivated en route to your doctor's office.

Personally, I would recommend you have your Botox and fillers treatment from a DOCTOR not an "injector". Furthermore, if the result is substandard, I would go back and give him/her a chance to correct it. If that does not work, see another physician until you find THE right one. You'll be glad you did.

Hope this was helpful.

Peter A Aldea, MD, FACS

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