Half of my Face Rotted Off! - Redding, CA~Say NO to Radiesse!

I am a cosmetic laser nurse and injected Radiesse,...

I am a cosmetic laser nurse and injected Radiesse, Restylane and Juvederm for many years. Last February the company sent a new injector trainer to show me and my staff the latest way to augment cheekbones to do the 'liquid lift'. I chose to be injected first before my volunteer patients to see how it felt.

She blocked the blood flow to my left cheek entirely!!! The product is incredibly thick, and this is a risk factor. I looked in the mirror and said, "You've occluded my blood flow." She shook it off and said, "Julie, you just know too much. Now relax and let me do the other side." My husband is the physician in our practice. I wanted to run down the hall and show him but she just downplayed it and kept injecting me. By the time she was through with me and my hubby saw it, it was too late. The tissue was dying.

For 6 months I had pain and disfigurement as my left cheek rotted off and had to regrow. Now, nearly a year later, I am left with pitted skin like severe acne scars. I have lasered it 5 times and only reduced the redness. I have spent thousands of dollars flying around california for medical advice to keep it from scarring, laser treatments, medicines, etc. The company had some Florida doctor call me from his car phone to tell me what to do and what to take. He was a total jerk. I asked the company to please send me to a California doctor so I could see them in person. They wouldn't. I was clearly on my own.

The company couldn't give a crap. They have NEVER called to check on me. The representative sent me one short email that basically said I was in good hands with my husband. That was it. The nurse felt bad, and was super sweet. But even she has not checked up on me since it all went down. I think they advised her not to email me anymore for fear of lawsuit.

I wish there was a class action suit.

They are getting away with horrible business practices.

3 1/2 years later... Much Better but still some residual scarring

I apologize for not updating this site. I've learned a lot over the last 3 1/2 years about ischemic events and how to heal them. I have also been blown away about how many people have had similar injuries. I was told this is extremely rare, but judging by the amount of personal messages I've received on this site over the last 3 years, it is NOT that rare. Radiesse cannot be dissolved like a HA. It can be dangerous when in the hands of an injector that does not know how to recognize an occluded or compressed facial artery. This experience has made me a more careful injector, and has inspired me to become an injector trainer. I am very excited about teaching injectors about how to recognize and prevent ischemic events. I hope the posts I've shared on this site help others heal emotionally and physically. I also hope injectors take the time to learn what immediate steps they must take if they happen to block someone's blood flow. I'm posting a photo of today. You can barely see the indentation from the skin I lost. I have had multiple laser procedures as well as injections of HA and Sculptra. I am very thrilled with the results, and grateful for the support I've received. I would like to personally thank my husband, Dr. Jory Kaplan for helping me heal so beautifully inside and out. I would also like to thank Dr. Randy Tate for his wonderful care during the toughest times. Dr. Victor Lacombe was also a huge help, and was brave enough to give me my first laser treatment. Finally, the support from my patients and family was absolutely beautiful. My patients have been so kind and understanding throughout the process. They let me inject them while my face was raw and disgusting from my injury. Their trust in me meant so much. This experience was bitter-sweet. Looking back, I can see all of the blessings that have come from this difficult journey. I find myself very grateful and in awe of how wonderful people can be. Blessings to all, and please feel free to contact me if this happens to you. I don't want anyone to feel as alone as I felt. Help is out there... and remember that you are beautiful no matter what is going on with your skin. :-)

How I Resolved My Scarring from Radiesse:

I am often asked on here how I resolved the extensive scarring from the ischemic event caused by Radiesse after their injector trainer blocked my blood flow to my cheek. The first 3 months required many wet-to-dry dressings, antibiotics, nitro paste (extremely painful), anti viral medications, aquaphore, xeroform dressings, and anti anxiety medicine. It is tough to relax when you don't know if you'll always look like a monster. I also would recommend hyperbaric oxygen treatments early on, but I didn't have this done due to time restraints.

After the first 3 months, I tried several things to address several problems over the last 3 years. My injury left me with hyper pigmentation, permanent hypo pigmentation, redness, and permanent pitting. Ironically, I used filler products for pitting, such as Juvederm and Sculptra. For the redness, I used a vascular laser (VP532 from a VersaPulse C). It's a dinosaur laser, but it works so well. For hyper pigmentation and pitting I also used both Fraxel Re:Store and Syneron's Sublative lasers. I also tried to break up the scar tissue with needles and microcannulas under my dermis. Finally, I used Obagi's hydroquinone cream to even out the color. It has cost thousands of dollars, even at cost, but I'm very happy with the results. The pitting and hypo pigmentation will be permanent, but I have managed to reduce it quite a bit with the above treatments. I hope this blog can help others move on after a similar injury.

Finally, I recommend healing your mind as well as your skin. This injury is both physical and psychological. It truly runs deep. It helped me to go to work and "face" my injury. I work as a cosmetic injector, so this gave me an opportunity to talk about the reasons it is important to have a knowledgeable injector who cares about what happens. It was extremely hard to do this, but it truly made me stronger and my patients appreciated the honesty and education. If this has happened to you, you may need to get professional help so the depression doesn't take you down. I went about life as usual, and even went forward with our planned mother/daughter Bat (B'not) Mitzvah 3 months after the injury with my bright red scar. Just know that there will be beautiful healing, but it will take a while. You are beautiful because your soul is beautiful, and your skin will eventually catch up. Take care, J.


Today marks the 4th anniversary of my injury.

I realized this morning that I am not angry at the injector who treated me that day. She didn't do this on purpose, and she probably learned as much as I learned that day. She probably suffered too. I feel badly for not doing the personal work to forgive her and reach out to her until today. I did reach out to her today, and hope she understands why I have not reached out until now. Forgiveness doesn't always go two ways, but hopefully it will in this case.

I have not yet forgiven Merz for dropping me like trash when I got injured. I chose not to pursue legal action, but I have not forgotten how rude and heartless the company was 4 years ago today. Perhaps if they followed up with me just once, I would be able to let it go. So far, nothing. I will not use any of their products on my patients going forward.

When I look in the mirror I still see physical scars from that fateful day 4 years ago. The funny thing is, no one else seems to see them. I consider them a badge of courage. This incident truly made me stronger, and I am proud of those pits and scars.

This week was interesting, as I found my poor, injured face plastered to some physician's website in Florida. He must have copied my photo from this site. He used my sad, pathetic face as an example, and didn't bother to block my eyes. I have mixed feelings about this. I posted here to spread awareness of what can happen, and what signs for injectors to look for, but I didn't ever dream I'd be copied and pasted without permission. Without permission, I cannot be sure the content out there is accurate or being used for prevention. I respectfully ask any and all people who want to use my photos to please contact me first on this site and let me know how the photo will be used, and tell me the context. I am all for spreading awareness, but don't want to be the poster lady for someone's personal gain.

Thank you for reading. For all of those who have been injured due to a vascular injury post injection, my advise to you is to be patient... sometimes it takes as long as 4 years (or more) to fully heal and reflect. Someday you may find that your soul grew throughout the experience, and it was actually a blessing. I have definitely become a better cosmetic injector, and a more compassionate nurse. Sometimes G-d gives us wonderful gifts, but not necessarily wrapped in pretty packaging.


4 years later

Just a tiny bit of pitting left after 4 years. I wear it like a badge of courage. This experience has been a blessing in countless ways. If this happens to you, DO NOT give up! Trust me, this is an opportunity to grow from within, and there is technology today can really help. Be patient...
Raidesse Training Nurse, Paula

I was injected by a very experienced Radiesse nurse trainer from the San Francisco Bay Area. She did not recognize my ischemic event (thought the blanching was from the lidocaine with epi) and did not follow the protocol for this injury to save my skin. I saw the large white area in the mirror after an injection and was frightened my blood flow was blocked, but I just trusted that she was right and I was wrong. I learned a big lesson that day, to always trust my gut and take immediate action if a blockage is suspected. HAs can be dissolved when this happens, but Radiesse cannot be dissolved. Please choose HA instead of Radiesse, and a qualified, experienced injector who really cares about you. The company that manufactures Radiesse (Merz), did not follow up or help me in any way. I felt so alone and afraid. They said, "Your husband is a physician. You are in good hands." I never heard another word from them, or from the Radiesse representative, Heidi MacKaben. I would never treat my patients the way BioForm Medical (now Merz Aesthetics) treated me. I sent all of my Radiesse syringes back to the company for a refund and they didn't even give me a full refund. They just don't care. I feel badly for the nurse injector because I can't imagine how that must have felt to cause such an injury. She was very kind. I hope that all injectors, regardless of their experience, degrees, or expertise, learn to recognize an ischemic event immediately so steps can be taken right away to reverse it. I hope that someday all injectors will be required to take a certification course, regardless of whether they are a nurse, physician's assistant, or a physician. This event inspired me to become more educated, so this has truly been a huge blessing in disguise. :-)

1 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
1 out of 5 stars Staff professionalism & courtesy
1 out of 5 stars Payment process
1 out of 5 stars Wait times
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I go to a well-known and highly respected Boston plastic surgeon for my dermal fillers. He warned me about staying away from both Sculptra and Radiesse, because once those fillers are used, it is hard to erase possible side effects and injuries to the skin. Both products settle in like cement. He told me of a patient who had to have parts of her face cut out to try and remove the infected portions from Radiesse. Don't mess with it. His favorite filler is Perlane. He's in his 70s and has been around a long time. Brilliant man, actually.
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Thanks for your detailed journey now I'm nervous if I should proceed with my injection. The great part is that you are over your hell & look beautiful.
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I too had a vascular injection, almost one year ago exactly. I am a 41 year old female and my life is forever changed because of it. My injector used a new technique that he, himself came up with 6 months prior. This consisted of putting tape across my check up toward my scalp, pulling the skin taught, and then injecting. he did tell me that he "got a blood vessel" but assured me that it was no big deal. He continued injecting, sent me off with an ice pack, and I left. 30 minutes later I knew something was very wrong. I went back to tell him but he had left for the day. The receptions told me that they had never seen a reaction like this, and to go to ER if I want to. The next day I had a horrible headache, my scalp was a weird color and I developed scabs all over that side of my scalp. Within 1 week, all of my hair in that region fell out. About the size of an orange. As if that were not bad enough, the real pain started soon after, and here I am 1 year later with trigeminal neuralgia from trauma. After trying many drugs like gabapentin and tegretol, my neurosurgeon has suggested microvascular decompression surgery. I cannot believe that this happened to me.
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Thanks so much for sharing your story. I am sad that it happened to you, but glad that you found a way to deal with it and are now much better. I am a victim of a botched rhinoplasty and have been through a very rough time with a disfigured face and guilt over going through a very unnecessary plastic surgery. Stories like yours (and also mine) have helped me learn valuable lessons in dangers of plastic surgery and really educating myself since many doctors don't do it for the fear of losing the business. You are gorgeous with or without any fillers.
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you are a beautiful woman without the injections - your face has more than enough volume and looks good. I am sorry this happened to you! Unfortunately, there are a lot of us out there with damage from cosmetic procedures.. I've been looking into fat transfer or filler injections to restore the volume in my face after the fat melted away due to IPL damage, but stories like yours warn me to stay away from fillers and stories of others are causing me to rethink the whole fat transfer idea as well. Happy everything worked out for you in the end!
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LFS, thank you for the kind words. I hope you find a talented, safe practitioner. That is a great place to start. It is honestly really safe if in careful, experienced hands. It stands to reason that the rare, scary cases are here. Still, these cases are super rare especially with experienced injectors. I wish you the best and am sorry to hear about your IPL injury. Sincerely, J
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Glad that you finally have healed inside and out. And you look beautiful, BTW. I learned something from you today. I had a bad experience with my plastic surgery, too, and I have to forgive for my well being and personal growth.
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I am glad your face looks so nice now :)
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Thank you, Duck. :-)
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Thank you so much for posting this. I had radiesse injected in my nose after a graft in my nose dissolved post-op. It was most likely due to infection. The UCLA faculty plastic surgeon injected radiesse to "build up" my nose. I was left with mottled blue discoloration, my skin texture became rough with grossly enlarged pores, I also developed a granuloma where some Radiesse was injected too superficially in the dermis. The surgeon (who has since left UCLA for Temple U) could not have cared less. He made an attempt with a VBeam laser to see if it could help with the discoloration (it didn't). He told me there was nothing left to do. The UCLA department of Plastic Surgery could not have been more indifferent. No suggestion of remedy or attempt to help. I have had IPL, KTP laser with not much improvement. I had an erbium laser treatment which did not help and I am scheduled to have a CO2 fractional "Dot" laser to see if it might improve the enlarged pores. My skin is adhered/tethered where the radiesse was injected. It has changed me and made me reclusive. Radiesse is an awful injectable. Restylane can be reversed with hyaluronidase but radiesse, which supposedly lasts just a few years, can cause granulomas that never go away, and awful changes to skin and blood supply. You are so fortunate to have access to caring medical professionals and to have medical knowledge yourself. Thank you for your positive attitude. I have not reached that point yet but I hope I can improve my skin and my outlook. Many blessing to you
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Oh, PlainJane, I am so sorry for your suffering. It helps to have medical professionals who care. Just know that many of us care about your healing process. The CO2 fractional laser may be a good idea for you. I really hope you have a successful result. The IPL and KTP are usually nice for taking the red or pink color out, but the pores need something deeper and stronger, and a fracitonal system may help the texture. It did help mine, and the IPL and KTP helped my color issues. Please keep us all updated on your healing process. Sending you many blessings too. (((((((hugs)))))))
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I was so happy to read that after all your suffering, you were at able to at least fix a large part of the damage that the nurse inflicted on your face. I can't even begin to understand your suffering all those years, but I am so happy that you emerged from your situation as a survivor who continues to give hope to others. Good for you!!!
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Thank you so much, ab81. It truly means so much to read your words.
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I'm so sorry you went through this. You're beautiful and have lovely eyes, by the way. Personally, I would absolutely never let anyone inject filler into me other than a plastic surgeon who is experienced doing injections.
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Thank you, deenerbug (cute name). Yes, experience with facial anatomy is important, and facial plastic surgeons have that. Still, there are other factors such as gentle hands, slow injections, artistic skill, and definitely years of experience. I guess the best way to find a qualified, safe injector is to ask your friends. Word-of-mouth is important. I hire nurses in our office, but I look for nurses with a surgical background. I believe a surgical background for aesthetic nurses truly helps them comprehend ways to be sure each procedure is as safe as possible. Continuing, education is also very important in this field. Now there are certifications to study for and attain. Thank you so much for you post! Julie
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So glad you are better. Having been through a filler nightmare, I can relate to you feeling guilty about your children having a depressed mom during this time. I thought I was permanently disfigured, and still have insecurities over it. Thankfully, I am better inside and out and moving on. Ladies, please tread carefully with fillers. I wouldn't wish this experience on my worst enemy.
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Thank you for your kind words, Clare. I'm sorry you went through a similar situation. We sometimes forget that when a complication happens, there are more people harmed than just the patients. Sending you continued healing thoughts. It is a process, isn't it?
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sorry for your experience, but to me its mind blowing a nurse is legal allowed in Cali, to do facial injections. No offense. I would NEVER EVER let any nurse do that to any patient....especially not to yourself. " Raidesse Training Nurse? " ( u mean Radiesse ) is that even a legal title in for a Registered Nurse? California? im seriously curious. I know Cali is so insane, they even let LPN'S or you guys call em LVN's be "trained" to inject filler. Its insane to me. I mean next thing u know, we'll have nurse in facial surgery or something! My advice, ONLY have facial injections ( Radiesse, Restylane, done, by medical doctor / dermatologist who is board certified by the American board of plastic surgery and has at least 5-10 years experience with fillers! Having said that, sorry you went through this, glad you are recovering well!!!
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Thank you Shawn. I have recovered well. Actually, I am a BSN, RN nurse injector. I work with my husband, who is an otolaryngologist and facial plastic surgeon. My background is in the OR, I was a surgical assistant. This gave me a strong foundation of facial anatomy, which is vital to being a successful cosmetic injector. I know it doesn't sound safe, but many of us have been injecting since this stuff came on the market. I'm in my 15th year of this business, and have never harmed a patient through injectables or laser. I have my husband down the hallway, and he sees every patient and delegates the procedures. My point is, it can work but many years of experience in the OR, and many years of experience injecting are extremely helpful. In California, you have to be at least an ADN (Associate Degree Nurse). You cannot be an LVN to use lasers or injectables. You need to be overseen by a physician, and the physician has to own at least 51% of the company. The physician needs to be available all of the time, but not necessarily on site all of the time. I am in school now to get my doctorate degree in nursing (DNP) and am nearly finished with my Masters in Nursing (MSN). I agree with you that education is vital. I am also fortunate enough to be a trainer, one of 125 nurses around the country who travels and teaches techniques and safety. So, I know your post is well-intentioned. I just want to give you awareness that there are many RNs around our country who are extremely capable, safe, and talented. There are many professionals, however, who are picking it up just to make some extra cash for their offices, and aren't bothering to get properly trained. These people have various degrees, including physicians. The people who really scare me are the confident-types who just start pumping it into people's faces, regardless of the risks, training, or results. Yes, the person who injected me was an RN, hired by the Radiesse company to travel to my office to show me the latest cheek filler technique. She came with as much experience as me, so I trusted her. I really feel badly for her because it must have been extremely difficult to go through what she went through. I think the two of us learned a powerful lesson that day, though. Now, when I see any blanching at all, I initiate the protocol for an ischemic event. I don't second-guess my gut feeling. That was my biggest mistake that day. Her mistake was not listening to me, and not erring on the safe side. I forgive her, and forgive myself. Still, my husband was just down the hall, and he helped a lot too... but by then it was too late. Anyway, thank you for your kind words and know that there are exceptions to every rule. ;-) Take care, Julie
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Julie, Thank you so much dear for ur kind and detailed reply, it actually educated me a little more about this. You are a rare case tho, that happens to have lots of experince and education. And I agreed with everything u said and I learned more :) ur btw very pretty :) Happy V Day to you! Take Care, Shawn
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Here in Indiana a nurse can inject fillers, as well.
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Thank you Shawn. :-) Julie
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I believe that nurses can inject in most states (if not all). My opinion is that is okay as long as the nurse is well-educated about facial anatomy, the products used, injection techniques, and is overseen by a physician who is suitably trained as well. I think it also helps to have a surgical background.
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