Radiesse Problems Three Months After Injection

Question

Radiesse injected into cheeks with no issue. 1 week later injection at lower cheek bone, much smaller amount. Since 2nd injections, serious swelling and still the case three months later. Large nodules on both lower cheeks, felt from inside of mouth. Now have large pouches either side of my mouth and hollowness under the cheek and fullness at jawline. Question: Can nodules cause prolonged swelling? Will pouches/fullness disappear and skin return to normal? Thank you

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

Harold J. Kaplan, MD · Answer

Hi Dublin.  As you have been advised by the other practitioners, you must visit your injector.  Nodules, hard bumps and/or prolonged swelling are all potential Radiesse side effects that should be addressed by your injector directly.

	Better to know for sure what's happening than continue to guess.  Good luck.

Ron Shelton, MD · Answer

YOu have an unusual development after Radiesse injections and should see your doctor who injected it. There could be infection or granulomas that need treatment. It depends on which areas are swollen and which areas were exactly injected to determine if the nodules might be obstructing some venous outflow of blood return thereby causing swelling. See your doctor for an evaluation.

Samir Shureih, MD · Answer

The formation of NODULES after injection of long lasting filler like Radiesse can be due to injection technique, infection, granulomas.

	See your plastic surgeon who injected the material, aspiration of the large nodule may yield an answer, otherwise further workup may be needed. Meanwhile frequent massage, using your finger and a massager.

	External ultrasound may dissipate the Radiesse.

Steven Wallach, MD · Answer

Radiesse can cause nodules. It can be a lump from the amount of filler or a local reaction to the filler. You should be checked out by your treating doctor.

Mary P. Lupo, MD · Answer

I would be most concerned about infection. Other possibilities are granuloma formation (rare, but not unheard of) or bolus injection that was not properly massaged, or deeper hematoma that is now organizing with scar tissue. There are things that can be tried to improve these and shorten the duration, so return ASAP.

Emily Altman, MD · Answer

Usually Radiesse dissolves within one year after injection without any problems.  On rare occasions patients may develop a foreign-body response to the crystals with formation of nodules.  These noduels are difficult to treat.  Sometimes intralesional injections of triamcinolone may be helpful.

	I suggest an evaluation by a dermatologist with experience in fillers and potentially a biopsy of the nodules to determine exactly what the cause of the nodules is. Edema from nodules is transient and should not be occuring three months after injection.

Barry L. Eppley, MD, DMD · Answer

While Radiesse is a good filler and is long-lasting, it is partially composed of particles which give it its longer last effects. Any particulated injectable filler is sensitive to injection technique and is more prone to lumps/nodules than non-particulated fillers. Once these nodules or lumps develop, there is no good way to work them out. It is the result of uneven deposition of the material and the effects of gravity in the cheek area. It is a self-solving problem with time as the filler eventually resorbs. All with eventually return to normal.

Mitchell Schwartz, MD - Account Suspended · Answer

You need to be reevaluated by your injecting physician. This could be an infection that needs to be treated with the appropriate antibiotics. Inflammation caused by allergic or "granulomatous" reaction can be evaluated and treated as well. Hopefully your injections were done by a physician using proper sterile techniques.

Radiesse Problems Three Months After Injection

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