One side of my face is bigger after Radiesse and Sculptra. What can be done?

Question

Hi there, I had Sculptra and Radiesse injected my cheeks earlier this year and unfortunately I now have one cheek bigger than the other. It gives my face a very a-symmetrical look and I don't like it. I prefer the flatter side to the side where I was over injected but don't know what my options are (or indeed if I have any) to bring the other cheek down? Many thanks for your expertise in advance.

Raffy Karamanoukian, MD, FACS · Answer

Radiesse is a stimulatory filler that is an excellent option for patients who desire a longer-lasting filler alternative to hyaluronic acid dermal fillers. In our office, we use Radiesse to complement structural areas of the face and contour bony prominences. Our office also is a center of excellence for filler complication treatments and we see patients who have been treated by other doctors and have undesirable results from Radiesse or other long-lasting fillers. We have treatment options available for Radiesse filler nodules, granulomas, and soft tissue thickening. The first step would be to diagnose the nodularity and determine whether there is an option for surgical vs. non-surgical removal. Surgical excision is a possibility in some patients; whereas others with more diffuse fillers may benefit from intralesional therapy using scar modulators and enzymes and kenalog. Radiesse complications may be long-lasting and prompt action is key. Patients who have no access to an expert in the field should begin gentle massage of the areas of nodularity with Plato’s Scar Serum twice daily. RF and invasive lasers can actually do more damage by stimulating further collagen growth.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

There are a few options. 5fu/steroids in combination with venus legacy treatments can help reduce this. See an expert for a formal evaluation. You can even out the face with other fillers as well.  Best, Dr. Emer

Monika Soni, MD · Answer

Thank you for your question. I do not understand why you had a combination of Radiesse and Sculptra injected into your cheeks. For the unevenness, I suggest you have the side that I flat injected. Even though you like the flat side better at least both cheeks will be even out. Unfortunately, there is no alternative to decrease the larger side. I recommend seeing a expert injector in your area to determine the best treatment plan for you.

Hardik Soni, MD · Answer

Thank you for your question. I do not understand why you had a combination of Radiesse and Sculptra injected into your cheeks. For the unevenness, I suggest you have the side that I flat injected. Even though you like the flat side better at least both cheeks will be even out. Unfortunately, there is no alternative to decrease the larger side. I recommend seeing a expert injector in your area to determine the best treatment plan for you.

Melvin Elson, MD · Answer

There is no good alternative to decrease the side that is too large.  I don't understand why you had a combination of Radiesse and Sculptra. At any rate at this point since the problem is the unevenness I suggest you have the side that is flat injected even though you like it better at least they can be evened out. Be sure you see a board certified dermatologist or plastic surgeon

Glenn Messina, MD · Answer

Sculptra gives subtle changes that have to be added to on the average of a vial per decade. If you only have had a single treatment I would believe that it is the radiesse causing the a symmetrical cheek. Radiesse is excellent for cheek enhancement but is not reversible like hyaluronic acid products ( volume, restylane lyft , juvederm etc)

The good news is the radiesse will break down in time however that could be many months. If this was very recent your physician may be able to still manipulate the injected Radiesse and flatten the cheek to look more like the other side.

There is another possibility and its a good one. If this treatment is only a few days old you may just be seeing asymmetric swelling , most of us inject maintaining a mental count of how many tenths of a cc of product is in each area. Unless one side received a lot more Radiesse than the other  once the swelling resolves you may be quite pleased. Please keep us informed.

One side of my face is bigger after Radiesse and Sculptra. What can be done?

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