How Long Does Radiesse Last?

I agree with the previous authors on most points. In my opinion, Radiesse should not be used for treating the tear trough orinfraorbital hollowing. There are better solutions with a small particle size. While patients may tolerate surface irregularities, granulomas, or assymetries in the nasolabial, these complications are more difficult to tolerate and treat in the eye region.

The bumps or surface irregularities can become very apparent under the eyes, whether a hyaluronic acid (Restylane, Juvederm, etc), Sculptra, Radiesse, autologous fat, or silicone particle-based solution is injected.

We fortunately can expect some improvement with Wydase in reversing the hyaluronic based solutions. Specifically with respect to Radiesse:

• If the bumps are readily visible a short time after injection, an immediate consultation should be requested with your physician and aggressive massaging may help.

• If discrete white bumps are visible, then a small incision can be made to "milk" out the material. These usually will not leave a permanent or visible scar.

• Direct surgical excision becomes extremely difficult in chronic (more than several months) because of the foreign body reaction and encapsulation with fibrous scar, and should be avoided unless absolutely necessary.

• However, if a concomitant blepharoplasty can be performed, then either excision or camouflaging with a layer of either crushed fascia or Alloderm can sometimes improve the appearance.

I would avoid any further injections to the eyes during this period of resolution. And while the manufacturers may state the product may last for up to three years, I have observed a time period of one year or so a more reproducible time period.

It slowly goes down with time but can last for longer than a year. In fact biopsies of areas that have had radiesse injections have shown that it can last up to 3 years or more. But the volume that remains later on is no more than 30% of the original volume that was injected. The area that is injected also determines how long it lasts. In more mobile areas, the effect is less and goes away faster.

The Radiesse around your eyes will probably be there for at least a year.  It will get better each month so hang in there......

Dr Grant Stevens    

Radiesse first came to the United States about 10 or 12 years ago as Radiance FN. Due to trademarking issues the name was changed to Radiesse. The chemical composition of the material is calcium hydroxylapatite particles suspended in a water based gel carrier. The initial claims by the manufacturer were that the material would last 4-5 years once injected. Our clinical experience over the ensuing few years made it clear that the product was persisting for somewhere between 12 and 18 months depending on where it was injected. To the company's credit, much free product was distributed to Plastic Surgeons to reinject our patients that we had promised 4-5 years of effect.

In your case, it sounds like the shorter duration will act to your benefit. Injecting around the lower eyelids is precarious, at best, as you now well know, and I do not reccommend Radiesse for the tear trough area in my patients. Vigorous massaging of the treated areas may help to hasten the absorption of the product. Lumps and bumps may be camouflaged with the injection of either Restylane or Juvederm around them to even out the area. If they persist beyond one y

Radiesse is known as calcium hydroxyapatite. It is similar in structure to dental enamel. It is quite biocompatible, but because of its thicker nature needs to be placed in the deep dermal layer of the skin. When injected, it is roughly 70% gel carrier and 30% active ingredient.

In most cases it takes 10-12 weeks for the absorbable carrier gel to go away. A good amount of the product injected into your under eye region should go away. But I would recommend aggressive massage.

Occasionally, if the Radiesse is too superficial, a 16 or 18 gauge needle can be used to make a small incision in the skin to milk out the Radiesse.

Radiesse is an excellent injectable implant for the naso-labial furrows and for the corners of the mouth and we use it frequently. However we do not use Radiesse in the area around the eyes because complications and side effects may be frequent and long lasting. The size of the needle required to insert the material can create substantial trauma and bruising to the thin and fragile tissue in the area below the eye. The material is thick and can at times be seen through thin tissue in this area.

When lumpiness became a problem in the early experience with Radiesse for lip augmentation (most experts recommended avoiding use of Radiesse in the lips), many of us realized that this could be an even more significant problem around the eyes. Finally the potential for "retinal artery occlusion" is also a fear we share with others.

Radiesse is not the only injectable implant that has demonstrated the potential for problems in the area under the eyes. Use of hyaluronic fillers is also associated with long term edema or swelling as well as discoloration. However we do have an antidote of sorts for these fillers while there is none for Radiesse. Having stated this I am becoming more and more conservative on the use of any filler in the trough area with the exception of injectable fat used through an open "transconjunctival approach".

Once a problem has become evident, as in your case, there are some doctors who feel that Kenalog (steroid) injections may help dissolve the material, but there can be side effects to this type of treatment and we have not found it helpful. At this point camouflage, massage, and cover up make-up may be the only alternatives. Ultimately, complete resolution may take up to one year.

I have used Radiesse in my practice since 2003 and have found it to last for about 12 months (I agree with a previous post which stated 9-15 months). However, in my hands, the primary indication and the greatest level of satisfaction has been for treatment of the nasolabial folds (defining line that makes the junction of upper lip and cheek). Radiesse is a very viscous filler and is most suitable when used to fill areas where the skin is thicker. Typically the region of the tear trough and periorbital skin (skin around the eyes) is the thinnest skin in the body. Therefore Radiesse is more likely to be visible when injected in this area, and have a higher incidence of granuloma formation.

Definitely seek attention for this problem although it is likely to resolve spontaneously.

Hi Anon,

I do not use Radiesse under the eyes in the tear trough hollow because unlike hyaluronic acids (Juvederm, Restylane, and Prevelle Silk) it is not reversible. Sometimes hyaluronic acids can be used to camouflage the "bumps" until the Radiesse dissolves. Radiesse can last up to 9-15 months. Consult with your physician or with a physician who is very experienced at injections in this delicate area. The good news is that the Radiesse will eventually disappear.

Dr. Jeffrey Hoefflin's answer to your question is most complete and I agree with what he has said. I hope that your problem resolves most quickly. Be well.

Dr. P

 I have used quite a bit of Radiesse in the face to fill in the nasolabial folds, shape and augment the Chin, Cheeks and Jaw line since Radiesse became available for use here in the US.  Radiesse is meant to be injected into areas where a fatty tissue layer exists and this would not include the under eye area where the tissues and skin are extremely thin.   Radiesse lats about a year, so those lumps and bumps will be there for awhile before slowly resolving.  This is why I prefer a smaller molecule filler like Restylane or Juvederm for the under eye area, not Radiesse.

 Radiesse for Cheek Augmentation works great as lomng as the aesthetics of beautiful cheek size and shape is not volated.  You can learn more about the aesthetics of beautiful cheeks in my new book on the subject "What's Your Number...the palmer code".