I got my cheeks done with radiesse and loved it. It caused my already bad tear troughs to look worse, so I got them done too. Now I am on the fence: now that I got a little more in my cheeks I think i need my tear troughs re-done or touched up, but I don't want to look like Kim Kardashians been looking lately-with no line of demarcation between her eyes and her cheeks. What should I do?
Radiesse in Cheeks and Tear Troughs: Do I Need a Touch-Up?
Doctor Answers 12
Radiesse and cheek filling vs tear trough correction
Your photographs do not provide enough information to create useful advice. The smile in the one photograph pushes up against the eyelid muscle and creates rolls of skin and muscle of the lower eyelid. The flat appearance of the other photograph shows a different lower eyelid contour. If the tear trough is still needed to be corrected, Restylane is a great filler when used underneath the muscle in this area. Radiesse is great for the cheeks.
Restylane in the Tear Troughs
Your result does look fine and there is only a faint shadow remaining in the tear troughs. Restylane comes in smaller, half sized syringes which, in my office, are close to half the price and would be easy to use for a touch up if you desired.
Radiesse not for tear troughs
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Restylane NOT Radiesse for Under Eyes...
Go for a more natural look! Do not try to look "perfect". Radiesse is excellent choice for cheek volumization, NOT for treating the tear troughs!!! If you wish to have a little more injected under your eyes I would recommend you get Restylane -ONLY! It is safer and gives better results.
Hope this helps.
Dr. Grant Stevens
When considering to have more product injected, it is always best to error on the side of being conservative with the amount that you are having placed. It sounds as though the Radiesse in your cheeks has given you good results. Be careful when having filler placed into the tear trough area. It is better to go with a filler like Juvederm or Restylane in the under eye space. Radiesse can appear opaque under the skin, since the tissue is much thinner in the tear trough area and there is a chance it can migrate, creating a bead appearance.
Reviewing your photos it appears as if you have an improvement from the Radiesse
The issue is whether to accept the good improvement you already have or try to make it better
It becomes a personal decision
I agree with the other physicians who mentioned that if you try to obtain a further improvement in the tear trough region, for this type of "touch up" I favor Restylane, which is a hyaluronic acid gel
Cheeks usually need to be raised to efface tear troughs.
Cheeks usually need to be raised to efface tear troughs. Filler impalntation in the ceeks is usually best done at the level of the cheek bone and may be pushed superior to the bony margin.
How to determine if it's time for a Radiesse touch up
I will start by saying I do not recommend Radiesse in tear troughs. Radiesse is a great filler/biostimulator but has been known to cause more side effects in tear troughs and lips and should not be used in those areas.
In my opinion, Restylane is the best filler for tear troughs.
As to when it's time to do a touch up, if you are happy with your look, then wait 2-3 more months and see how things go. The problem with Radiesse is that if too much is injected, there is nothing to do other than wait for it to dissolve a year from then.
As for a line of demarcation between tear trough and cheek, in young faces there usually is not a line like that present, but it does depend totally on what you prefer.
Touch-up after Cheek and Tear Trough Augmentation
Remember, perfection can be our worst enemy. If you're hesitating, it means you're satisfied and I suggest you do nothing more at this time. Radiesse is temporary; as the improvement declines you will continue to re-evaluate your appearance and have a touch-up when necessary.
Radiesse could be used to make Right cheek fuller
Radiesse could be used to make the right cheek more full and round. Radiesse should not be used in the thin skin area of the tear trough as it's meant to be injected into fatty tissue which this area has none. Use Restylane or Juvederm there as they are much thinner and won't create lumps and bumps.