3 months after Radiesse, skin is still blue. Is this bruising or hyperpigmentation and what are my treatment options? (photos)

Based on your description, it is possible that the blue discoloration is related to a vascular issue, rather than hyperpigmentation. This could be due to the injection accidentally hitting a blood vessel during the procedure, which can lead to the development of a bruise or blue discoloration.
While hydroquinone can be an effective treatment for hyperpigmentation, it may not be as effective in treating a vascular issue like this. In this case, laser treatment may be a more appropriate option. A dermatologist can evaluate the affected area and recommend the best laser treatment option for your specific case.
Laser treatments such as pulsed dye lasers or intense pulsed light (IPL) therapy can help break down the pigmentation and reduce the appearance of the blue discoloration. These treatments can be effective in reducing the appearance of vascular lesions, and may be a good option for you.
It's important to note that while laser treatments can be effective, they may not completely eliminate the discoloration. You may need multiple treatments to achieve the desired results.
In summary, the blue discoloration you are experiencing after Radiesse injections may be related to a vascular issue, and laser treatment may be an effective option to consider. It's important to consult with a licensed dermatologist who can evaluate your specific situation and recommend the best course of treatment for you.

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

Tyndall - which is the proper name of the bluish discoloration - is a known adverse effect of Radiesse and most hyaluronic acid filler when placed too superficially in the skin. Skin thickness and color also plays a role. The only therapy is dissolving the filler - and yes - dissolving with hyaluronidase as soon as possible. Other therapies would be deep RF microneedling or laser.