Unhappy w/ Radiesse for the Corners of the Mouth - Options?

I got Radiesse injected in the corners of the mouth to improve a downturned look, but I am unhappy with the results. I just got the treatment yesterday and hope that the puffiness will go down but I'm not certain it will. The improvement I got with injections in the cheek area has now been negated by how my mouth area looks--it actually caused deeper marionette lines and it looks like I have cotton in my mouth. What can I do now?

Doctor Answers 16

Radiesse, give it time

BE PATIENT! I injected radiesse in same area in my nurse and she drove me crazy all day because she "looked like a chipmonk". Within two days the swelling that she had was down and it was just what she wanted. Hope you have the same experience. some places just swell more than others. I think that radiesse, restylane and juvederm, when correctly injected, do a wonderful job in this area. However, this is sometimes a very tough area to do well so should see someone that does this often. 

Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Radiesse for corners of mouth

There may be improvement in the next few days as the swelling improves. Otherwise see what your doctor can do to make it look better. It maylook very good to you in a few days.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Radiesse for marionette lines


In some patients, swelling from the injection process itself can take 3-5 days to resolve, so if you are just one day out from the injection, I would say to be patient with the result for now. Different parts of your face can disproportionately swell up, so the area around your mouth may be more swollen than your cheeks even though they were both injected at the same sitting. If in a week you still appear “puffy,” I would recommend speaking with your injector about your concerns. Oftentimes massaging the area can help the Radiesse dissipate somewhat. Good luck to you!


Sarmela Sunder, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Unhappy with Radiesse at the Corners of the Mouth

Apply ice and wait several days for the swelling to resolve. If your not satisfied, further treatment may be necessary. Unfortunately, the Radiesse will last longer than most temporary fillers.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews



The swelling should have gone down by now but if it hasn't you might benefit from some low dose steroid injections. Radiesse is not the a filler I would use for the marionette lines...



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Unhappy one day after injections

One day after injections is too early to start getting worried about results.  It may take several days for any swelling to resolve.  While injections are great treatments for filling volume deficits like the cheeks, injections around the mouth are more complicated.  If enough filler is placed to completely smooth out any wrinkles, then what too much volume is added.  There needs to be some understanding that fillers are great products but do not perform miracles.  There is a balance between volume and effect.


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Undesirable Radiesse results 1 day after injection

There is usually swelling for the first few days after Radiesse injections.  The first few days ice needs to be applied for 5-10 minutes every two hours to help reduce the swelling.  Give it a few days for the swelling to subside before making a judgment about how it looks.

Radiesse can give excellent results when used for buttressing the corners of the mouth.  The loss of soft tissue in the lower 1/3 of the face, as well as midface contributes to the formation of nasolabial folds and marionette lines, as well as the deepening of the corners of the mouth.

Radiesse can be injected into the soft tissues surrounding the mouth (not into the lips themselves) to add volume and to stimulate the skin's own collagen production in the injected area.

If augmenting the lip corners accented the marionette lines, you may need some volume added in the marionette lines or the upper cheek area. 

The difference between a youthful face and an older face is volume.  As the face loses volume in bone, fat and collagen, that's when the wrinkles and folds appear.  Replacing volume with minimally invasive procedures as opposed to tightening with a facelift goes much further to reversing the signs of aging.

Emily Altman, MD
Short Hills Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Radiesse is an excellent treatment for the corners of the mouth

When properly injected, Radiesse is an excellent treatment for the corners of the mouth. I disagree with the comments that "fillers are overused to compensate for more invasive procedures". Quite to the contrary, deeper volumizing "stimulatory" fillers like Radiesse and Sculptra are excellent choices to create a much more natural looking, youthful face without the down time, pain, and expense of surgical procedures. This also explains their dramatic increase in popularity over the past few years. I have been injecting Radiesse for over 8 years (well before it was FDA approved because of its dramatic ability to correct problems due to volume loss) and am on the Medical Education Faculty for the Radiesse Corporation. I can tell you that to get the best results it is critical to have an experienced physician injector. The video link below shows me injecting my wife with Radiesse in the lower cheeks and marionette areas and includes a one month follow up picture. My web site shows her excellent results four years later after her touch up. These results are far better than what could be achieved with surgery.

One day after your injections is too soon to worry about the outcome. Wait several more days to let the swelling go down. If you're still not happy, then you should return to the physician who treated you.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Radiesse, Beverly Hills Radiesse, Los Angeles Radiesse

 I use Radiesse and have ever since it's approval here in the US for all sorts of augmentation in the face.  Radiesse is a large molecule and does create more fullness than say Perlane, Juvederm or Restylane but it also lasts longer IMO. 

 In the area you mentioned, called the Marrionette Lines, Radiesse may look a bit full if over-injected but honestly, you'll need to give it 3 days or so to see the final result.  If you really think to much was used, go back to the dermatologist or plastic and cosmetic surgeon that did the Radiesse injection and ask them to massage the Radiesse in an attempt to disperse and flatten the areas. 

 Next time, you may want to consider using Perlane which is a smaller molecule and tends to cause less fullness and lumpiness...I prefer that in the marrionette lines.  You can also place a small amount of Botox or Dysport in that area to raise the corners of the mouth.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews


I agree with some of the responses about overuse of fillers To compensate for more invasive procedures Especially a filler like radiesse which is irreversible Keep ice on it and hopefully will resolve itself You need to have time on your side Good luck

Edward J. Bednar, MD
Charlotte Plastic Surgeon
4.8 out of 5 stars 125 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.