What to do about dissolving Radiesse?

Question

I had Radiesse injection in jawline 16 days ago. The R side has mass/swelling. I was told to massage & it would go down. It didnt. Yesterday I had it tx'd w/ 3 cc of NS to break down the mass but it didn't. I've read that sodium thiosulfate is a new tx option, but there is little experience with it. What is the protocol for Na2S2O3? 1 time or multiple injections? The dr who did my injection lives in another state. Is there anyone in Nashville who is experienced with Na2S2O3 to dissolve Radiesse?

Jason Emer, MD · Answer

Thank you for your question.Unfortunately this filler cannot be dissolved with Vitrase / hyaluronidase. A combination of fractional laser or radiofrequency, Venus Legacy treatments, and 5FU/steroid injections could help with the lump. Otherwise, aside from waiting to see if it goes away, the only other permanent option is surgical removal. I suggest getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Hylauronidase has many advantages and should be considered in patients who are unhappy with their results or in acute cases of overfilling or occlusion. Its often better to reverse filler and restart then to deal with long term edema. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jean M. Casello, MD · Answer

Yes there is a protocol now to dissolve Radiesse.  You should ask your injector to call the company or their rep  and they can give them the protocol.

Kamran Khoobehi, MD · Answer

Your pictures would have been helpful. I would recommend to wait few months and let your body heal. The mass can be hematomma, swelling or too much fillers.

What to do about dissolving Radiesse?

Answers (4)

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