Radiesse left huge nodules on my jaw line; what can be done to remove them quickly? (Photos)

Question

My plastic surgeon recommended that I have one syringe of Radiesse injected along my jaw line to correct a slightly saggy jowl. 2+ weeks post filler and I have large nodules protruding from both sides of my chin. The lumps are more pronounced now than the day after receiving the filler. My plastic surgeon said that it is not the filler and that I am to massage the hard moveable lumps. He said there is nothing he can do. The lumps are not softening/shrinking and easily roll around under my skin.

Jason Emer, MD · Answer

If you're unhappy with your Radiesse results, it can be improved with venus legacy treatments and 5/FU steroids. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

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

James DeStephens, MD · Answer

Radiesse works differently from the Hyaluronic Acid fillers such as the various Juvederm products.  It can work very well, but its not reversible.  Like the Juvederm products, Radiesse can also be significantly molded shortly after its placed in order to smooth it out but this needs to be done during the time of placement before you leave the office by the individual placing it.  Once it is placed and settled over the course of several weeks it forms calcium like cystals in the area of the subsurface of the skin where it is placed.  This helps to stimulate collagen formation which can also be beneficial to maintaining the integrity of your skin.  However, the HA products can be reversed if you don't like the results but Radiesse cannot be.  It will gradually fade away over the course of 1.5-2 years but not so sure when it is apparently been placed in a "glob" as it seems in your case.  However, a minor incision by your plastic surgeon underneath the jawline where it wouldn't be seen would likely allow for the 'moveable nodule' to be easily removed and you can start all over once it has properly healed.  Your result usually happens from someone who has no experience with dermal fillers.  Anyone who has done any filler work at all routinely massages the filler to 'smooth' it out.  It looks like this was not done.  I have used Radiesse myself and it has always worked well.  However, it isn't my preferred filler.  I stick to the newer Juvederm products.  They are easy to use and can last up to 2 years.  If someone over does something it can always be reversed easily with something called Hyaluronidase which is injected into the area.  Consider your situation to be a nuisance and an aggravation but it can be fixed simply enough as I have suggested.  A good many plastic surgeons don't do the filler work themselves but have a trained aesthetician do it.  If such was the case for you, the aesthetician was not properly trained.  Good luck but again, its easily fixed by simply removing the nodule with a small incision and a little local anesthetic.  No big deal in the end.  BTW, no xrays should be necessary for this.  The history makes it obvious as to what this is and the hard lumps that are easily movable also consistent.  Just have them removed.  
Dr. DeStephens

Melvin Elson, MD · Answer

First of all to determine if the lumps are due to Radiesse an Xray will show the presence of the product.  injection with cortisone may help but it also looks like if it is Radiesse it can be extruded. see a board certified dermatologist experienced in the use of Radiesse

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

HI, Radiesse can not be dissolved with an injection or any skin surface based treatment.  Radiesse is calcium based which means that neither steroid nor hyaluronidase will dissolve it.  Delivering energy to the calcium hydroxyapatite will "not" dissolve it either despite some claims to the contrary.  Only "time" will be effective at making Radiesse go away.  This is one of the downsides of using Radiesse versus the HA fillers that can be dissolved with hyaluronidase.  For this reason, I prefer using Restylane Lyft to shape the cheeks, chin and jaw line.  There are however, occasions that I will use Radiesse to augment the mandibular angles in men to create "flare" to the jaw line.  Hope this helps.

Radiesse left huge nodules on my jaw line; what can be done to remove them quickly? (Photos)

Answers (5)

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