1 month post op Radiesse, there is a nodule and skin over the nose. It is red and peeling. Is this normal? (photos)

Question

I had radiesse into bridge of nose a month ago. The dr seemed to overfill d area bet eyebrows.i didn't say anything as I thought it's usual swelling & it will look normal in some days.Now,after a month,it's looking very prominent like a nodule (I feel d filler)& skin over nose is red and peeling .there is NOpain.im worried -is it inflammation or infection?I went to the same dr -he did a steroid shot & antibiotics for 2weeks. the thing isI can NEVER take antibiotics as it messes my whole system

Jason Emer, MD · Answer

This is an example of poor judgement and lack of experience in using fillers in this area.  Radiesse can do very well in the nose, if injected properly and diluted appropriately.  My suggestion is to go to an expert to camoflage the area with a different filler.  You may need steroid or saline injections into the Radiesse area to help "break" it apart, unless you are willing for it to subside on its own (can take up to 1-2 years).  Botox in that area will help it from clumping up anymore as well.  I have tried radiofrequency treatments with sublative and thermage which has also helped in the past.  Massage and heat can help as well, but at this point are less likely to be beneficial.  You need to see an expert for an evaluation.  Good luck, Dr. Emer.

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

Ryan Mitchell, DO, FAOCO · Answer

It is very important that you have regular follow up care with your injector during this time.  If your doctor recommended antibiotics then I think you should take your doctor's advice.  If you have reservations about taking the antibiotics then go back to see the doctor ASAP and let your doctor know that you are being non-compliant with the prescribed treatment.  Without examing you it is difficult to know if there is an infection.  If you did have an infection however, the area will typically get worse.  Infection will cause progressive redness, tenderness and inflammation.  The redness alone is a sign of inflammation.  Not all inflammation necessarily has gross infection.  Without knowing specific details about your case it is too difficult to give you more advice.  You do need to see your doctor however until this situation is known to be under control.  "This answer has been solicited without seeing this
patient and cannot be held as true medical advice, but only opinion. Seek
in-person treatment with a trained medical professional for appropriate
care."

Joseph A. Eviatar, MD, FACS · Answer

If this occurred immediately after treatment, I'd advise you to follow up with your doctor immediately, since this may be an early sign of an occluded vessel. Since it's a month later, the Radiesse can be injected to reduce the nodule.  I strongly preferJuvederm for contouring the nose, since it can be reversed with Hylenex.  At this point 5FU or very low dose steroid injections can help to break up lumps caused by Radiesse.  If the skin in the area is red
and flaking, using 2% hydrocortisone might relieve the symptoms.   Make sure to see an injection specialist who is familiar with treating these issues and can re-inject later if needed.

Sheryl D. Clark, MD, FAAD · Answer

I would be reluctant to inject #Radiesse in this area.  HA fillers are safer and reversible.You will need to go back, possibly for multiple sessions, with saline injections, or 5 FU, and possibly Pellevé, ultrasound, or Thermage. If your physician thinks antibiotics are appropriate, I would tjae them and then take probiotics to help your gut to recover (Orthobiotics is an excellent brand and you can get this on Amazon.com).This will get better with time. So sorry you are having to go through this.All the best! Dr. Clark

Steven F. Weiner, MD · Answer

I'm not a big fan of nasal injections with filler, particularly with non removable fillers like Radiesse. This appears to be a problem and is difficult to fix. Try breaking up with massage and saline injections. Otherwise it will need to be cut out because it will last a long time in this area.

Alan M. Engler, MD, FACS (retired) · Answer

You should be seen by one or more plastic surgeons in person to see what if anything can be done about this.As you probably know, there is no way to "reverse" Radiesse, as there is (to a limited degree) with HA fillers (by using hyaluronidase - one of the better known trade names is Vitrase).  It is, therefore, that much more important to have it injected "accurately" (not that there is 100% certainty with any treatment or procedure, including fillers).I generally prefer to limit fillers to the lower half of the face - below the level of the eyes.  I normally recommend neurotoxins (such as Botox, Xeomin or Dysport) for treatment of the glabella, crow's feet, and forehead.For specific treatment in your case, though, you should be seen in person after which any treatment decisions can be made.I hope that this helps and good luck,Dr. Alan EnglerMember of RealSelf100

1 month post op Radiesse, there is a nodule and skin over the nose. It is red and peeling. Is this normal? (photos)

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