I am only 39 and I didn't have severe jowls or anything... just annoying laugh lines that I wanted to make less noticeable before my high school reunion. The injections hurt substantially but once those are over there's very minimal soreness. My skin was a little hard for a couple of months at the injection site, but it didn't bother me at all and wasn't noticeable to the eye... only if I pressed on it. Make sure you don't smile or laugh for at least two days & the effect will be better. Also sleep on your back and don't smash your face into your pillow.
The radiesse lasted for about a year. It's been 16 months and I am definitely getting it done again this year. I don't know where some people are finding this procedure for $500, I paid $1800. Overall, if you can afford it and are looking for a SUBTLE change (not a miracle) it is worth it.