Indentation that won't go away (Photo)

Question

I have been getting filler for a year now, in June I was injected with radiesse for cheeks. I have been getting this indent on the left side of my face for a few months, when I smile. I had my cheek injected where the indent was and within a few weeks it's back! It will look nice and full for a few weeks and then it starts coming back! Why is this happening??

Raffy Karamanoukian, MD, FACS · Answer

Radiesse is an FDA-Approved filler that we use very frequently in our office to sculpt the contours of the face. Since we are a national center of excellence for filler reversal, we also encounter patients from other doctors' offices who wish to have Radiesse fillers removed for one reason or another. In our office, we employ a directed technique to visualize the filler material, if possible on ultrasound, and then use non-surgical methods to dissolve the filler or granuloma tissue using intralesional injections. There are many methods using a combination of enzymes, intralesional modulators of scar tissue, and Kenalog to help reduce volume and remaining filler. These techniques require meticulous attention to detail and can be performed at intervals of two to three weeks to achieve longterm effect.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Cynthia Stolovitz, MD · Answer

The indent you have is the ligament below the eye that attached deep to the bone on the cheek. 
This is very hard to fix with fillers because it is part of your anatomy.
Initially it may look good after fillers but it  usually comes back  even if you inject small quantities of a light filler on top. If you look at old pictures of yourself you will probably see that you had this before.
My advice is to accept this as part of the charm on our face!

Henri P. Gaboriau, MD, FACS · Answer

The dent you are referring to is usually due to an anatomical variation of your cheek fat pads. Of course it is difficult to assess on a picture only. Radiesse is usually injected deep to the fat pads. if the dent is more superficial then you may need another filler layered on top, like Juvederm Ultra Plus. I do combine them quite often to achieve a lift (Radiesse or Voluma) and then a smoother contour (Juvederm Ultra Plus). Hope it helps.

Indentation that won't go away (Photo)

Answers (3)

Recommended reading

Everything you need to know about Radiesse

Our mission is to create a world where every investment in modern beauty is Worth It.

Indentation that won't go away (Photo)

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Radiesse

Our mission is to create a world where every investment in modern beauty is Worth It.