Radiesse under eyes - inflammation or granuloma forming? At which point steroids?

Radiesse is an excellent product with a wonderful safety profile, but I do not use it around the eyes.  Granuloma formation is unlikely with the use of Radiesse but inflammation and some irregularities can occur, especially in the thin skin and muscle layer of the lower eyelid.  I would be very conservative in your approach to managing this hopefully, temporary side effect. Inflammation should subside and an oral steroid may be a better choice than an injection of steroids as injectional steroids can lead to other changes of the skin and soft tissue that are irreversible.  Once the redness subsides, gentle massage will help with any residual lumpiness but other interventions can be used at that time as well.  

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

I'm sorry that you are experiencing these problems, but without pictures it is difficult to determine exactly what is happening.  Radiesse is not generally injected under the eyes, unless you are referring to the cheek areas.  I would make an appointment with a doctor who has experience with Radiesse so that you can be fully evaluated and treated appropriately.