Fillers Don't Seem to Work to Volumize my Face?

At age 47 I had a facelift. At age 57 I had a "facelift revision" and now at age 64 I've had another facelift revision. All by the same surgeon. He recommends CO2 flat-beam resurfacing but said that he couldn't "plump" me out. I had 3 Radiesse injections on the cheek bone. The results disappeared after 3 days! I suspect that other injectables in the cheeks will have zero results. No fat on my body to transfer (5'11", 125# male). Another PS blamed it on genetics and told me to "eat more".

Doctor Answers 17

Consider other fillers

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You may want to consider Volume or Volift (juvederm products) that are thicker in consistency for better volume enhancement.


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Remember that fillers come in very small amounts. As an example, a syringe of Restalyne 0.7 -1 c.c. sells  around $550. There are about 5 c.c.'s in a teaspoon so a full syringe of a filler, such as Restalyne, has a total volume of about 1/5 of a teaspoon. You can see that you should not expect a radical change in the volume of your face with a filler. If a person needs volume perhaps a better solution should be to consider facial implants such as the cheek, pyriform area (around the base of the nose) lips -excellent! and chin. All of these have been performed for years under a local anesthesia in the office.   

Robert E. Zaworski, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 61 reviews

Fillers not working

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Radiesse is great for spot filling and increasing definition, but for general volume it is not what I would recommend.  With no fat to graft, I would recommend Sculptra which works as a diffuse soft tissue enhancer.  Usually 3 injection sessions are required- doing it just once will unlikely help so you need to be committed to the process. 

Fillers Do not Work and No Fat for Fat Grafting

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     No fat for fat grafting - how lucky.  I have never seen Radiesse disappear in three days.  Other fillers can be tried to assess response, like some of the HA derivatives.

Adding Volume to the Face

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For volumizing, my favorite method for cases such as yours is Sculptra,
that can, with two to as many as four treatments, provide a nice amount
of filling into the areas that lack volume.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Adding volume to the face

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Sorry to hear about the issue you are experiencing. Don't give up hope, there are other options available for adding volume to the face. One great option is Sculptra. It works very well to restore fullness to the face.  It is not a real filler, it is an injectable suture.  That being said, it is not as predictable as a filler. It causes irritation of the dermis and collagen formation. The collagen regeneration takes time, and it is not quick like a filler. Usually, multiple treatments are necessary to get the desired result.


Another option you may want to consider is a vampire facelift. For this procedure, we use PRP, or platelet rich plasma. We take some of your blood and spin it down into a centrifuge. We then get the plasma, which has the platelets in it. We remove and discard the red blood cells, and are left with a yellow serum that has all the growth factors. The serum has all the great factors of blood, plus the platelets, which stimulate everything to grow inside, such as the collagen, or angiogenesis. This makes new blood vessels and is great for your skin. You can then inject the PRP into the face, just underneath the skin. Over time, you can get around 10-15% more volume in your face, which can last a few years. It takes about 8 weeks to see. The procedure also gives you a better glow. It helps with your pores and your blemishes, and it gives you overall healthier looking skin.

While your cheeks are full from the PRP injection (cheeks will be full for four or five hours), we also take filler, and will put that in the cheeks and lower eyes. The filler is injected through the same little cannula (hole). The filler will remain for six or seven months. Overall, everything is performed in one procedure that typically only lasts an hour. I think you would be very happy with the result! Please feel free to ask me any specific questions and I would be happy to answer them for you.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Fat Transfer Injections

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Dear loneskate,

  • For volume without adequate fat supply, you should look into Sculptra
  • I love doing fat transfer injections, and usually avoid Sculptra because of the results I can get with fat
  • There is a small population of patients (those without adequate fat) that would benefit from Sculptra
  • Be patient because depending on how much volume you want, it could take multiple sessions

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Disappearing Radiese

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This is a common issue with many patients. as of your low weight for your height, fat transfer may not be a viable option for you. I don't think the radiese disappeared, but rather that more radiese needs to be added. Unfortunately, this gets expensive, but it is the only option for some patients.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

Volumizing after Facelift

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The lack of volume after Radiesse injection is likely due to small amounts of injection, rather than loss of the product.  The overall loss of volume in the face is not uncommon as we age.  I would consider fat grafting for increasing volume.  Even in very slim patients, enough fat can usually be harvested for facial grafting.  As always, it is important to consult with a reputable, board-certified Plastic Surgeon with your concerns.

Jarrod Little, MD
Louisville Plastic Surgeon
4.9 out of 5 stars 22 reviews

Facial Implants can be used instead of repeated filler injections

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Although it would be impossible for Radiesse to disappear in 3 days, I suppose it could disappear in several months. Other potential options would be use of facial cheek implants, but without photos and/or an exam it would not be possible to tell if you are a good candidate.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.