Can Radiesse Reveal Old Acne Scars?

Radiesse is injected deeply into the skin and won't reveal old acne scars.  You make start looking closer at your skin since you got the radiesse and start to see old scars that were always there before.

Hello.  What you are pointing out is certainly possible.  Especially in convex areas of the face (those outward rolling areas) like the cheekbones, adding more volume in the dermis can make the cheeks appear fuller and more rounded, but it can also cause the skin to be stretched slightly from the additional volume. 

This stretching may make older acne scars more apparent.  This would be similar to finding small imperfections on a balloon as it is blown up.  As the surface area increases, the imperfections become more visible.

Radiesse is not injected superficially as it is viscous (thick) and meant to be injected between the dermis and subcutaneous fatty layer. I doubt that the filler would be placed so high in the dermis that it would fill up the skin around the ice pick scar making the depressed scar look deeper.  What I have seen in practice is that Radiesse which is used during my panfacial augmentation procedures to revolumize the face when significant atrophy of the fatty layer has taken place, is that the deep folds which have skin that is not seen for years that traverses down along the walls of the fold, are now raised and are visible.  With this skin that formerly hid in the shadow of the deep crease walls now raised, the surface epidermis imperfections are seen again for the first time in years. This is the same as using your hands to pull the skin back and make a tighter face, the way people do when they want to see how they would look after a facelift, and then see the skin for the first time in years that was hiding.

Ice pick scars can be treated with different techniques such as the CROSS technique with TCA (trichloracetic acid) or punch grafts and then resurfacing. There are risks and these need to be discussed in detail with prospective patients.

Massage for now is the quick fix. You should return to the surgeon who did this as he knows where he put the Radiesse and if what you  see is temporary or will it take a prolonged time to resolve.

When any injectable is done, other areas, such as old acne scars, reveal themselves. It’s like painting the walls and not painting the ceiling. Suddenly you realize all the chips and cracks that you didn’t see before. If you restore volume to an area of the face that was hollow, you may notice these acne scars now because they were lost in the hollowness before treatment. Lumps from Radiesse are usually palpable, you can feel an actual nodule if there’s really a lump, and when you smile in your face you will often see that.

This is likely from the volume of the radiuses causing the light to reflect off your cheeks differently, now making the eye pick up scars that were previously in a shadow. Laser resurfacing is the treatment of acne scars. Your injecting MD will be able to tell if this is product or volume effect.

It is possible that the induration from Radiesse placed superficially may cause the skin to be indurated and accentuate ice pick scars. Early on, Radiesse can be massaged and even broken up with some saline and needle subsicion. Go back ASAP as after 2 weeks, it is hard to manipulate the material.

Radiesse lumps look just like a lump.   Firm, round to irregular.

You describe an ice pick scar that is more apparent after injection.  I suspect that this is because the scar doesn't expand like uninjured skin, and the wide pore at the surface is distorted with the injection.

sek

Sometimes when the skin is lax or wrinkled, the ice pick scars from years ago are not visible as there is no firmness and they tend to sink in a little.

When a filler is injected, they are brought more to the surface and become more visible.  The same happens with hyperpigmentation.  When it is in a hollow area, there is more of a shadow there and the light is not reflected off it, therefore making it less visible.  When the area is filled, there is more light reflected from it.

Lumps from Radiesse are usually not tiny and you can feel them when you run your fingers over the area, even if not visible from the surface.

If the scars are really tiny, they should respond well to fractional resurfacing.  Talk to your dermatologist or plastic surgeon about it.  Make sure the fractional resurfacing is done by a board-certified dermatologist or plastic surgeon with training and experience in treating acne scars.  Fractional erbium laser tends to have fewer side effects than fractional CO2.

If the Radiesse was placed to superficially or in to large an amount, the skin can take on an orange peel appearance and that would accentuate old acne scars.  Ask the MD that did the Radiesse if you can massage the area.