Is there any way to fix this Radiesse mess? (photos)

Question

I recently lost weight due to an illness and lost a lot of face volume. A doctor injected radiesse into the hollows if my cheeks, and it formed little pea-like bumps, giving me a chipmunk look. It also made my marionette lines and sagging Joel's worse. The doctor insists this is normal and will even out, there is no need to do anything. It's been 8 weeks, and it looks worse than ever. Please tell me if there is anything that can be done to fix this!

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

Young R. Cho, MD, PhD · Answer

Thank you for your question, and I am sorry to hear about your experience. Radiesse is normally a very well received procedure.  At this point I would recommend that you see a more advanced dermatologist or plastic surgeon injector and avoid the use of Radiesse as this cannot be reversed.   The doctor can evaluate you to see if you have granulomas that can be treated with steroids, or if additional filler product may help smooth things out.

Henry Mentz, MD, FACS · Answer

Thanks for your question and photo. I'm sorry to hear about your experience with Radiesse. Be sure to visit a certified nurse injector specialist and/or board certified plastic surgeon for these procedures. Fillers such as Voluma and Juvederm can help restore volume back to the cheek area.

Samuel Baharestani, MD, FACS · Answer

It looks like your body has formed granulomas to the Radiesse that was injected into your cheeks.  Likely, the material was either injected too superficially or migrated to that location afterwards.  Make sure that your injector is aware of your concerns.  From your photo, this looks like an unusual area to inject Radiesse.  There are several other fillers that are much better for superficial injection in the cheek, eg Juvederm or Belotero.  Hopefully, with time your body will metabolize some of the problem and the lumpiness will improve.  Good luck!

Harry Goldin, MD · Answer

I am sorry you did not have a good outcome with your filler.  I think the material was injected too superficially and not evenly.  You will probably have to wait 1-2 years for the product to be dissolved by the body.  It seems to me that you could look better if you had the filler injected into your cheeks (deep-above the bone) to lift the cheeks up.  This may help your complaint of more drooping.  You might want to go to a different doctor since you did not get a good result with the first.

Melvin Elson, MD · Answer

After 8 weeks the cheeks should not have small bumps. it may be the material was injected unevenly or too superficially.  It is diffciult to straighten this out but it can be done. Be sure your doctor is a board certified dermatologist or plastic surgeon and has experience treating this side effect

F. Victor Rueckl, MD (in memoriam) · Answer

Unfortunately Radiesse is not dissolvable which means it has to go away on its own from your body metabolizing it over time. If you can feel pea-sized bumps then it was injected too shallow. Sometimes small amounts of kenalog injected superficially can help with some Radiesse bumps, but it can also cause divets, so it is a very tough procedure to do unless you have significant experience. The kenalog doesn't dissolve the filler but it helps break up the lumps of it. The Radiesse will go away, but over about a year's time. I'm sorry for your experience. You could see another injector and see if some HA fillers like Voluma or Restylane could be injected to help lift the areas that look the worst, but I'm not sure you want to endure more fillers at this time. The good thing about HA fillers is that they can be dissolved, unlike Radiesse. I do not recommend Radiesse for first-time filler patients because of issues like you are having. I will only use Radiesse on someone I've injected before and we both know how that person desires their fillers to look."This answer has been solicited without seeing this patient and cannot 
be held as true medical advice, but only opinion. Seek in-person 
treatment with a trained medical professional for appropriate care."

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