Surgical excision of Radiesse.

Question

Is surgical excision of radiesse possible? Some doctors say it is, some say it's not. If so, could you please provide a specific reference of someone who has performed this procedure?

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Michael I. Echavez, MD · Answer

While it would be possible to surgically excise an area that was injected with Radiesse, I would not normally recommend this.  Radiesse slowly gets absorbed over time and usually goes away within a year or so.  Surgical excision would result in a scar that would last a lifetime.

Ivan Vrcek, MD, FACS · Answer

Sorry to hear you're having this trouble. While surgical excision is an option, it is often the last resort. Steroid injections, 5-FU injections, and other options may be less invasive. I published a case in Orbit in which we used a KTP laser and saline injections to dissolve misplaced Radiesse in the lower eyelid. I have found this technique to be very successful. Whatever you choose, find an experienced surgeon that you trust.

Best of luck!

Best of luck!

John R. Burroughs, MD · Answer

Very rarely, Radiesse can cause a reactive nodule that may be uncomfortable and/or unsightly.  If it is superficial it can be removed with a small needle and squeezed out.  For larger areas, I have had success with steroid (kenalog) injections.  Only twice, have I had to remove them surgically when referred in to my practice.  I never recommend Radiesse into the lips or lower eyelids as this is where I have seen the most issues.  Best regards.

Quenby Erickson, DO, FAAD, FACMS · Answer

Radiesse is a bio-absorbable filler which dissolves slowly over a period of 6 months to a year so excision should not be necessary.  For best recommendations, please submit a photo so that we can properly guide you to the best care for your particular situation. There are very good aesthetic doctors in the Houston area, Dr. Chilukuri in particular may be able to help you. He is an excellent board certified Dermatologic Surgeon. I hope this helps.Dr. Quenby Erickson

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  Excision of an area where Radiesse has been injected would be not only difficult (think of tissue like a sponge that has spots or droplets of Radiesse integrated within the sponge...difficult to remove) but would lead to tissue indentations or deformities that would be permanent.  This makes no sense to do when the Radiesse will eventually dissolve on its own.  This is one reason that I prefer using Rsetylane Lift to shape the cheeks, chin and jaw line...it can always be dissolved should the patient decide to do so (which is very rare).Hope this helps.

Mitchell Schwartz, MD - Account Suspended · Answer

It is now possible to successfully dissolve a Radiesse nodule by doing an injection treatment.An article was recently published in the Journal of Drugs in Dermatology (Volume 15, Issue 9, Sept 2016) showing rapid resolution of a Radiesse nodule after it was treated by intralesional injection. The nodule was injected with a combination of 5-Fluorouracil, Dexamethasone, and Triamcinolone. The following day the nodule had reduced in size by 50%. One week later it was 90% resolved, and after 6 weeks it was completely resolved.If your nodule is bothersome enough that you prefer not to wait for up to a year or more for the Radiesse to be reabsorbed, you should seek a physician who will do this treatment.

Surgical excision of Radiesse.

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