Michael Sinclair

Radiesse is a great dermal filler but it is not a very good choice for injection directly into the lips. Radiesse is 30% powder (calcium hydroxyl apatite) and 70% gel carrier. When you inject the Radiesse into areas where there is not much movement, such as the nasolabial folds, the cheek bones, the lower jaw line, etc, it does a great job of changing and enhancing the facial contour. IF the Radiesse is injected into the lips, which are much more mobile (lips move with talking, eating, kissing, etc) the calcium hydroxyl apatite powder tends to form clumps. There is no chemical available to dissolve the lumps, which means you will have to live with the lumps for many months. Radiesse can be injected (off label) underneath the skin of the upper lip to flatten some wrinkles, but this technique takes practice and experience. If you want to enhance the shape, size of fullnes of your lips, Juvederm is a much better choice than Radiesse. For most of the rest of the face, I think Radiesse is an excellent choice. In fact, when I am performing facial rejuvenation, I frequently use both products in the same patients.

Dear Julesc, Hyaluronic acid fillers are much better at fixing contour defects than fixing wrinkles. The area between your eye brows should probably be treated with Botox first and then a resurfacing laser. The Botox will relax the muscles underneath the frown lines so the wrinkle stops getting worse. The laser can stimulate the growth of new collagen to try to smooth out the wrinkle you already have. Fillers between the eyebrows can be risky. Putting filler in between the eyebrows can cause an ulcer that will last for months. By treating the frown lines first with Botox and then waiting 2 weeks, you will minimize the volume of filler you will need. The upper lip wrinkles (aka smoker's lines or kisser's lines in non smokers) are very hard to treat with fillers. The best result I have seen using fillers is to have the filler injected perpendicular to the lines and then massage the filler to try to flatten the skin of the upper lip. Trying to inject filler into each individual wrinkle usually raises the skin underneath the wrinkle but does very little to get rid of the wrinkle. In my opinion, treatment of upper lip wrinkles is much better performed with a resurfacing laser.

Dear Jeanette, What are you are describing sounds like the swelling is from bruising. My concern is that after 3 days it should be getting better. If it is not getting better, an infection would also be possible....and much more serious. Have a doctor look at your lip. If it is not infected, then there is no harm in waiting a few more days to see if the swelling goes away. If the swelling does not go away, then it may be that you have too much Juvederm or a lump of Juvederm which could be treated with Hyaluronidase. If you just have a small lump, then you may not need to be retreated. If there is too much Juvederm, then you may have to start over. Don't guess or wait.....go see a doctor asap. If your lip is infected, you need to be treated immediately.