Can Radiesse never dissolve? 10 months post-op. (photos)

Question

Had radiesse injected for hollowing cheekbones last MARCH (2nd/3rd time in area over 3 years). Had tear troughs done about 1mth later (1st time) using other filler. Suddenly over last 4 days, 2 ridges where original radiesse was injected. VERY noticeable. Saw doc who said it is 'shadowing' - filler has worn off & I should fill in underneath, to plump it up.I did not have this before the filler. Why would it occur so long after being injected?? cannot feel any kind of ridge/bump. Help

Raffy Karamanoukian, MD, FACS · Answer

Radiesse is a stimulatory filler that is an excellent option for patients who desire a longer-lasting filler alternative to hyaluronic acid dermal fillers. In our office, we use Radiesse to complement structural areas of the face and contour bony prominences. Our office also is a center of excellence for filler complication treatments and we see patients who have been treated by other doctors and have undesirable results from Radiesse or other long-lasting fillers. We have treatment options available for Radiesse filler nodules, granulomas, and soft tissue thickening. The first step would be to diagnose the nodularity and determine whether there is an option for surgical vs. non-surgical removal. Surgical excision is a possibility in some patients; whereas others with more diffuse fillers may benefit from intralesional therapy using scar modulators and enzymes and kenalog. Radiesse complications may be long-lasting and prompt action is key. Patients who have no access to an expert in the field should begin gentle massage of the areas of nodularity with Plato’s Scar Serum twice daily. RF and invasive lasers can actually do more damage by stimulating further collagen growth.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Nelson Lee Novick, MD · Answer

I began using Radiesse many, many years ago when it was first introduced under the trade name of Radiance. So, I have many years of personal experience with this product. It is a calcium-based volumizing filler that, unlike hyaluronic acid-based injectable volumizers, does not have a specific enzyme like hyaluronidase to easily dissolve it in the event that there are complications or  unwanted or undesirable results (which seems to be the case here). It is for this reason that I have virtually stopped using this product save for patients who have been receiving it for years and who insist continuing to receive it. In the cheeks, which are not subject to excessive mechanical stress, Radiesse may last up to two years.  I have had personal success in breaking up and hastening the resolution of Radiesse-related problems such as yours using a combination of subcision to mechanically break up the product and make it is easier for the body to remove; the injection of saline to further help in this process; the injection of intralesional anti-inflammatory agents, like triamcinolone, when contributory inflammation is felt to be playing a role; and yes, even hyaluronidase for its effects on shrinking the surrounding tissue and bringing down lumps and bumps. You would do well to consult with a board certified aesthetic physician. Best of luck.

Anteneh Roba, MD · Answer

Radiesse is a filler that is supposed to last up till a year. Since you last had Radiesse injection only ten months ago, the filler is still where it was placed. It’s hard to say if the ridge is due to the Radiesse, but if that was all that was used at the time, it could be the cause of the ridges.

Stephen Mandy, MD · Answer

Your story suggests that your Radiesse injected 10 months before is not the cause of your current problem, mainly because at that point the Radiesse is largely gone. Rather what you have is fairly typical suborbital edema due to the recent tear trough injection which is not an unusual adverse consequence and can be corrected by injection of 20 units of hyaluronidase in the area starting near the medial canthus of the lower eyelid.

Neil Sadick, MD · Answer

Radiesse is a semi-permanent filler that lasts over a year. More importantly it has the ability to stimulate your own collagen production, a process that peaks around 3 months post treatment.

Can Radiesse never dissolve? 10 months post-op. (photos)

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Can Radiesse never dissolve? 10 months post-op. (photos)

Answers (6)

Answer: Peculiar mid face ridges after tear trough injection

Answer: Peculiar mid face ridges after tear trough injection

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Everything you need to know about Radiesse

Our mission is to create a world where every investment in modern beauty is Worth It.