Can HA filler be dissolved if i had Radiesse injected as well?

Great question—and it’s one that comes up often with patients who have layered or combined fillers.

Yes, hyaluronic acid (HA) filler can still be dissolved even if Radiesse (calcium hydroxylapatite) was also injected in the same area. HA fillers can be broken down using hyaluronidase, an enzyme that specifically targets and dissolves HA-based fillers. Radiesse, on the other hand, is not affected by hyaluronidase since it’s not made of HA—it’s a completely different substance that cannot be dissolved enzymatically.

However, there are a few things to keep in mind:

1. Anatomical Overlap:
If the HA and Radiesse were placed in distinct layers (for example, Radiesse deeper near the bone and HA more superficially), then dissolving the HA should not disrupt or affect the Radiesse.

2. Precision Is Key:
A careful, experienced injector can target only the HA filler with hyaluronidase. Ultrasound-guided injection can sometimes be helpful in identifying filler placement if the anatomy or filler history is unclear.

3. Puffiness Assessment:
If you're feeling puffiness, it’s worth determining whether it’s from the HA filler attracting water, delayed swelling, or simply a layering effect from having both fillers. Removing the HA might reduce this, but some puffiness may persist if Radiesse is contributing to the volume.

Summary:
Yes—you can dissolve the remaining HA filler without affecting the Radiesse, as long as the treatment is carefully performed. This is a common approach when patients experience puffiness or change their aesthetic goals after combination filler treatments.

The kind of puffiness seen in the photo may in fact be what has come to be called an under-eye "puffy pillow, which is actually lymphatic obstruction or lymphedema related to the use of an inappropriate choice of filler for the under-eye region ond/or too superficial injection of filler into the region. Unfortunately, this problem can be a persistent and long-lasting issue, as well as a difficult problem to treat. I have had gratifying results in patients who have come to me with this complication using varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert. Best of luck.