Darker Under Eye Circles After Radiesse

Question

I had Radiesse under my eyes for my tear troughs in February. I didn't see any results, and it even made my dark circles darker with a deep shadow. Why is that? What can I do about this? Would it go back the same way before?

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

Trevor M. Born, MD · Answer

Dear Cmcsec1
The color under the eyes is the result of several factors- pigment in skin, blood vessels under/in the skin, the muscle under the skin (the muscle can be seen thru thin skin) and tatooing from bruising.
When a filler is placed in the hollow area it pushes the dark skin forward and the color becomes more obvious.  if there is staining then a light retinoic acid  or very small amount of Triluma as per your physician may help speed up the color.
Good Luck!
With Warm Regards,
Trevor M Born MD

Michael A. Persky, MD · Answer

Hi C,

The injections of Radiesse under your eyes may have caused some bleeding and bruising. When blood cells break down under the eyes they leave behind pigment that can darken the area.
Using warm compresses for a few days may be helpful.

The other effect is shadowing that sometimes is exaggerated by increasing the size of the cheeks.

Eventually your under eye area should return to the way it was before your injections. 
Good luck and be well.

Dr. P

Christopher L. Hess, MD · Answer

The tear trough deformity can be a difficult problem to fix.  Deep fillers such as Radiesse can be a great solution to the problem.  However, the injector must understand the anatomy and thus the amount of filler needed.  You may also need a layered filler.  Meaning Radiesse deep over the bone and a hyaluronic acid filler like Juvederm in the superficial tissue.
The dark circles under the eyes are due to the blood vessels being more visible.  This is likely because the Radiesse is pushing them more superficially. 
So you might want to consider a lower lid blepharoplasty with fat redraping.

Darker Under Eye Circles After Radiesse

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Darker Under Eye Circles After Radiesse

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