Too Much Radiesse in Lower Cheeks (Male)? (photo)

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

    I would wait at least a couple of weeks and maybe longer before thinking about any touchups.  Injecting something else before that time when bruising or swelling is present just confuses the issue.  Kenneth Hughes, MD Los Angeles, CA

Radiesse is an excellent product for non-surgical cheek augmentation/enhancement. As others have said, it should be placed right on top of the bone and gently molded or sculpted at the time of placement by your doctor. After 24 hours, any additional massage will not likely have a significant effect but could cause more swelling.

Achieving the right balance in midface and peri-orbital rejuvenation and cosmetic enhancement is at least as much art as it is science. An overfilled cheekbone area may may the eyes look sunken in. This is particularly true if the under eye area already has a bit of a hollow appearance from volume loss or drooping of the cheek fat pad. The best treatment for this is avoidance... but, if there is a differential between these area, a different kind of filler can be used (such as Restylane) for the "tear trough" region. Best of luck!

I would recommend waiting a little longer before considering any other treatments.  At 6 days after your Radiesse injection to your cheeks, there still will be some settling taking place.  I would wait at least another week or two and then see how your appearance is.  At that point, it may be possible to use additional filler to help.  

By adding volume and fullness to the cheeks, it is possible to make the tear troughs look more pronounced. I would advise waiting the full two weeks for swelling to decrease and bruising to minimize, then return to the Dr who injected you. Best of luck.

Radiesse is a product I use daily because of its excellent duration and high patient satisfaction when injected appropriately.  It certainly does cause some swelling of the soft tissues in areas where it is placed and I would recommend allowing a full two weeks prior to consideration of any additional filler.

I rarely placed Radiesse directly into the nasolabial folds because of the unnatural appearance this creates, rather, I place the product where the patient has lost facial volume which is typically high along the medial and lateral cheek.

Best Regards,

Jacque P. LeBeau, MD

I don't think there's much you can do about it at this point but I also think it's too early to start layering around what was done.  In general, Radiesse is an excellent treatment for exactly the areas you describe; ie, cheek augmentation.  It needs to be sculpted at the time of injection into the appropriate shape.  At six days, you probably have swelling distorting the appearance and, at any rate, I don't think you can still have it shaped.  I would wait a few weeks and then consider additional fillers as a temporary solution.  And you should, of course, stay in touch with your own plastic surgeon.

I hope that this helps and good luck,

Dr. E

Radiesse is injected deeper than other fillers and so the underlying bruising and swelling can take longer to settle down. Regardless of what you see on the surface, swelling underneath is still there at only 6 days out. You need to give this time to settle down, at least 2 weeks out, to determine if you need to have more filler added.