What is it? Redness & 2 swollen areas remain 3 months after Radiesse (Photos)

Question

About 3 months ago I underwent radiesse treatment in the periorbital area. The right eye gave no problems but under the left, almost at the level of the cheekbone from the nose to the end of the sickle eye, there was swelling and very evident redness. Over time the swelling has decreased but the redness and two swollen areas that are neither hard nor painful remain. According to the doctor it is not filler but a subcutaneous edema because the radiesse would have been injected into the muscles.

Anna Chacon, MD, FAAD · Answer

Radiesse is a dermal filler that is commonly used for smoothing moderate to severe facial wrinkles and folds, such as nasolabial folds (the creases that extend from the corner of your nose to the corner of your mouth). However, it is not typically used in the periorbital area (around the eyes) due to the thin skin and sensitivity of this area.

Persistent redness and swelling for three months post-treatment is not typical. While it's true that Radiesse can cause temporary swelling, redness, and bruising, these side effects usually resolve within a few days to a week. Persistent symptoms could indicate an ongoing inflammatory response, possible infection, or a reaction to the filler.

The doctor's explanation about subcutaneous edema suggests that there may have been some trauma to the tissues during the injection process, causing fluid to accumulate in the tissues. This could be due to the injection technique or the depth of injection.

It is advised to have a follow-up with the treating physician or get a second opinion. A detailed examination and possibly an ultrasound or MRI may be necessary to better understand the underlying cause of the persistent redness and swelling. In some cases, treatment with antibiotics, steroids, hyaluronidase (to dissolve any remaining filler), or surgical intervention may be necessary.

Remember, it's crucial to seek immediate medical attention if you experience severe pain, vision changes, or signs of infection such as fever and chills.

Nelson Lee Novick, MD · Answer

At least from the photos provided and from the history of persistent post-treatment under-eye swelling, the problem here is likely to be what has come to be called an under-eye "puffy pillow," which is actually lymphedema or lymphatic obstruction that resulting from either  the use of an inappropriate choice of filler for the area and/or too superficial injection of the filler in the delicate tissues of the infraorbital region. Radiesse is generally not recommended for treatment in the infraorbital region, since there is no agent that can easily dissolve it should there be an untoward cosmetic result or an adverse reaction. Instead a variety of more appropriate HA fillers have been developed specifically for use in this region., which can be relatively easily dissolved with hyaluronidase. 
Unfortunately, infraorbital puffy pillows are generally difficult, persistent, and resistant problems to treat. Fortunately, I have had personal success treating it in patients who were injected elsewhere employing an algorithm of varying combinations, concentrations, and amounts of Intralesional anti-inflammatory agents. You would be wise to consult an experienced, board certified cosmetic dermatologist filler expert and best of luck. .

What is it? Redness & 2 swollen areas remain 3 months after Radiesse (Photos)

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What is it? Redness & 2 swollen areas remain 3 months after Radiesse (Photos)

Answers (2)

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Everything you need to know about Radiesse

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