Radiesse Sagging - Would More Filler Like my Cheeks?

"Santa Jowls",

I agree partially with what others have said in response to your question.  I would like to put this spin on it.  I assume that you, like most people who have facial fillers are looking for subtle improvement without surgery.  Like everything, it's all about your expectations.  It is difficult to make comments based on one photo, but here is what I think.  Overall, your face appears to have lost volume.  You can seen in the picture more on the left side where the area below the cheek bone prominence looks flat.   On the right side from the front, this is seen as a shadow that runs from the corner of the eye at the nose down toward the back part of the jaw.

The trend with fillers is to, as you have pointed out, is to try to restore midface volume, which 1) tends to pull subtly above the nasolabial folds, and 2) draws attention away from the nasolabial folds.  Completely effacing the folds directly  leads to the look you describe.  Why? Because the fold is a natural anatomic region.  The fold becomes more prominent as you lose fat in the areas above the fold and the tissue sags. Filling the fold itself does not treat the cause of the problem in the first place.   Therefore, I do like to try to fill the areas just under the cheekbone prominence.  This can be done with any of the fillers commonly used, such as Restylane, Juvederm, Radiesse, etc., as well with the relatively new Sculptra Cosmetic.  Fat transfer is also something to think about.   Yes, there are surgical options, but your question about placement of filler in a different location is a valid one.   Hope this helps...

You might only be noticing the jowls more now because the smile creases arw better after the filler. You could benefit by more filler in the marionette lines but that won't address the jowls nor would more mid cheek augmentation. A facelift would help lift the jowls.

There might be some swelling but inspite of that you have a problem. The radiesse was injected in the wrong areas.

Id this persist then see a BOARD CERTIFIED PLASTIC SURGEON  TO DISCUSS YOUR OPTIONS.

Radiesse can not be disolved and in certain areas can persist for a long time

You problem may require surgery to comouflage the radiesse