Radiesse (calcium hydroxyalapatite) is a fantastic filler for the nasolabial folds, which sit at the junction of the inner cheek and upper lip. However, it is (in my opinion) far too viscous a filler for correction of tear troughs. In fact, I would strongly caution a patient to stay away from this attempt at solving the problem.
I think it is important to first explore the causes of "under eye bags". In younger patients (20's-30's), it is more likley to be related to prominence of fat pockets that surround the globe (eyeball). In more mature patients (40's and up), the problem becomes more complex: patients usually have some degree of prominence of fat pockets, combined with midfacial descent, changes in muscle tone, and lower eyelid skin excess.
Although the concept of filling tear troughs has come into play in the last few years, it is certainly a very imperfect solution, because it doesn't address the changes I referred to above. I would go so far as to say that I have not yet seen a very good result from tear trough filling, with any form of filler, in anybody's hands. If the changes are dramatic enough, lower eyelid blepharoplasty (via the transconjunctival approach in younger patients and the subciliary approach in more mature patients) is generally a more complete, albeit more involved solution. Obviously, surgery is not for everyone, and I would not advocate it as such. Unfortunately, filling of tear troughs is generally a poor alternative; a patient's expectations should be modeled around the strength of a procedure.
