Pain from Radiesse 2 years later - can anything help this?

Question

I had hyperdiluted Radiesse injected into my neck, declotte and the space between my cheeks and jaw bone over two years ago now. I started noticing that I had a golf ball sized lump beside my thyroid around 4-5 months later, my face was swollen and my eyes looked like I had allergies every day. I am fatigued every day and started having intense pain in the submantle area and neck. Cold wind would intensify this, and if I cried the area felt like it was on fire. I was told to wait 2 years and the pain would subside. I’m past the 2 year mark now and it’s still extremely painful. It feels like it constantly burning and aches persistently. I had been taking prescribed gabapentin and Allegra to try to settle things, but i can’t work while on gaba as the side effects are too much and I’m a health care provider. Ithe Allegra helped clear my eyes. I was recommended to try Alleve, but it only took the edge off and I got a kidney infection from taking too many. I’m at my limit for pain and really need advice. Any help is appreciated, thank you.

Anna Chacon, MD, FAAD · Answer

I’m very sorry you’re dealing with this. What you’re describing is far beyond the expected recovery course after hyperdiluted Radiesse, and I do not think it should be dismissed as a normal “wait two years and it will settle” situation.

A few parts of your story stand out to me:

A golf-ball-sized lump near the thyroid region that developed months after treatment
Persistent facial and periorbital swelling
Burning, aching pain in the submental and anterior neck area
Pain that is triggered by cold wind and crying
Symptoms persisting more than two years later

That pattern raises concern for a delayed inflammatory or granulomatous reaction, fibrosis involving sensory nerves, or another process affecting the soft tissues of the neck rather than simple residual filler presence.

One important point

Radiesse (calcium hydroxylapatite) is not like hyaluronic acid filler—there is no enzyme that can simply dissolve it. By two years, much of the original carrier gel should be gone, but the product may have stimulated collagen deposition, fibrosis, or chronic inflammatory changes that can persist after the visible filler has largely resolved.

The burning quality of the pain matters

Pain that feels burning, stinging, electrically irritated, or worsened by cold exposure often suggests a neuropathic component. In the submental and upper neck region, irritation or entrapment of branches of the transverse cervical nerve, great auricular nerve, or other superficial sensory nerves can produce symptoms that patients describe very similarly to what you wrote.

I would not continue taking large amounts of NSAIDs

Since you’ve already experienced a kidney infection after heavy Aleve use, I would be very cautious about ongoing high-dose NSAID therapy without physician supervision.

What I would want evaluated

At this point, the most useful next step is usually imaging of the neck soft tissues, particularly:

High-resolution ultrasound performed by someone experienced with cosmetic filler complications
In some cases, MRI of the neck with contrast if ultrasound is inconclusive

The goal is to determine whether there is:

A persistent nodule or granuloma
Fibrotic tissue
An enlarged lymph node or another unrelated neck mass
Involvement of deeper structures around the submandibular region
Treatments that may help depending on the findings

If a granulomatous or inflammatory reaction is identified, physicians sometimes consider:

Intralesional corticosteroid injections
5-fluorouracil (5-FU) injections
Combination steroid/5-FU treatment for fibrotic nodules
Referral to a facial plastic surgeon, dermatologist experienced in filler complications, or interventional radiologist

For the neuropathic pain component, alternatives to gabapentin that are sometimes better tolerated by working healthcare professionals include medications such as pregabalin at very low doses, duloxetine, or other neuropathic pain strategies, but those decisions need to be individualized by your treating physician.

The eye swelling and fatigue

The fact that Allegra improved your eyes suggests that at least part of the swelling may have had an inflammatory or histamine-mediated component, but persistent daily fatigue would make me want to ensure that other systemic causes are not being overlooked, especially since the neck lump was initially attributed to the filler without definitive confirmation.

The most important thing I want to emphasize is this: persistent severe burning neck pain, swelling, and a palpable neck mass more than two years after Radiesse is not something I would consider a typical post-filler experience, and I would not simply continue waiting for spontaneous resolution. You deserve a thorough evaluation focused specifically on delayed filler complications and neuropathic neck pain, because there may still be targeted treatments available that could significantly reduce your pain.

Pain from Radiesse 2 years later - can anything help this?

Answers (1)

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