Tissue damage and swelling from Radiesse and aggressive manipulation?

Question

Excessive radiesse injected in the massater muscle area of my jaw. Aggressively tried to manually manipulate the radiesse for about 3 months after injection.15 months after the injection, if I touch that area of the massater muscle, it feels painful and it responds by becoming inflamed. Area disproportionately large. I cannot tell if the disproportionate size is due to remaining radiesse or long term persistent swelling. There is not an original injector to consult.

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

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Accents Cosmetic Surgery and Medical Spa · Answer

Thank you for your questions. Your concern is valid and should be discussed with a board certified plastic surgeon due to it occurring after a cosmetic injection. While there may be some filler remaining in the area, it being 15 months is enough time for such effect to resolve or almost be resolved.

Robin A. Sykes, MD · Answer

This is a difficult problem to deal with, absent an exam and a lot more questions that need to be answered.  At 15 months, I would expect the Radiesse to be gone or almost gone,  I am wondering if there is something else going on, like with your parotid gland, for example, or  something unrelated to the filler.  I suggest that you seek the opinion of a board certified plastic surgeon, to try and sort this out.
I wouldn't ignore it!  Good luck.

Steven F. Weiner, MD · Answer

I don't believe this plane is the right plane for injections in the jawline. It can cause the masseter irritation you describe. Consider dissolving the filler using sodium thiosulfate. I inject in the more superficial plane, pre-platysmal plane.

Tissue damage and swelling from Radiesse and aggressive manipulation?

Answers (4)

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