Malar edema caused by voluma/radiesse in cheeks and mid face. Any suggestions?

Hi @smp110! I'm sorry you are dealing with these complications. I recommend dissolving the product with Hylenex then getting Morpheus 8 done. Morpheus8 is a non-surgical treatment for full body skin resurfacing, skin tightening, and fat reduction of stubborn areas. It uses minimally invasive fractional radiofrequency energy (RF) to penetrate the skin deeper than other microneedling devices, triggering the skin’s natural healing response to promote skin tightening and lifting. Best of luck, Dr. Nima!

Thank you for your question and I am sorry to hear of your filler issues.  If you feel that you still have product remaining I would advise dissolving the Voluma with hyaluronidase while waiting out the effects of Radiesse (which should be nearly completely resolved).  Hope this helps.

Please post photos for further evaluation. There is no way to give treatment advice without photos or an in person consultation. Best, Dr. Emer

This is definitely a complicated problems to deal with. I have treated people several years after cheek or undereye filler who had persistent swelling in the undereye area. Removal of the filler with hyaluronidase has remedied most of these problems. Interestingly, these treatments were performed in some cases at a time when the filler should not have been there. I would recommend removing any of the hyaluronic acid filler (Voluma) before considering any other treatments. The unknown is that Radiesse cannot be dissolved or removed and needs to naturally be broken down. Typically, this occurs very early and the product is replaced with collagen. So the problem is that the Radiesse/ collagen is there and cannot be reliably removed with surgery. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

It is important to know what exactly was placed in your cheek. Voluma will slowly absorb and is gone in many after 2 years. However, in some it may lasts longer. The enzyme to remove it can be tried first. Without photos, I cannot give any specific recommendations.

Malar edema associated with fillers can be helped with superficial injections of Vitrase into the malar edema.  Several sessions may be needed and deeper injections of Vitrase also may help.  Another option is injections of kenalog10/5FU into the deeper areas that may be producing the edema.

Thank you for your question smp110. Voluma and Radiesse are great products to enhance the cheeks. They are designed to last up to two years. If a treatment was done two years ago, the material has likely been metabolized. Voluma is a hyaluronic acid product, but it can be difficult to dissolve because of the high level of cross-linking. Radiesse is a calcium product that cannot be dissolved with hyaluronidase. Please follow up with the doctor who did the initial injection for recommendations as he/she knows you and the treatment done best. Good luck!