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

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.

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

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.

Hi,

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!

Dr.Sunder
 

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

Wait several days and ice the area. If it is nOt satisfactory return to your surgeon or get a second opinion.

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. 

Don’t worry about it if you got it recently. I would usually give it a month. If it feels hard or lumpy you can massage it a few times a day for 1-2 minutes with a little bit of moisturizing cream. But don’t look at the results as permanent at this point. After a month, you should return to the doctor to see. If it seems very hard or like there’s too much, doing massage for the first week after treatment may be helpful.

Radiesse is a great "structural" filler--I enjoy using this product to rebuild cheeks and help the jawline and perioral area.  However, I caution patients that this filler, in my experience, can cause more swelling and bruising, especially in delicate areas such as around the mouth.  I use Radiesse judiciously and conservatively at the corner of the mouth. Over correction can cause the appearance of a white bump or leave to uneveness.  Other fillers and biostimulatory agents can also be used to treat this area--Perlane, Sculptra (for the entire perioral/jawline area, Restylane and Perlane)--these products are sometimes more foregiving.  In addition, your physician should address the structural changes in your entire face.  Often lack of volume in other areas of your face (or lack of bone support) can be the cause of changes around the mouth. 

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.