No Improvement After Initial Radiesse Injections?

I am a male, had radiesse injections into each cheek a few weeks ago because both cheeks are flat. The plastic surgeon said to come back in a month because I will need another injection in each cheek for a full correction. But after a month, I have no noticeable improvement. Both of my cheeks are still flat. Should I go back in and get another injection in each side and see if that helps? Should I see a different plastic surgeon? Or should I switch to Restylane or Perlane?

Doctor Answers 10

No Improvement After Initial Radiesse Injections?

After fillers its very common to have swelling on the area for the first 2-3 weeks. Once healed, patients tend to think the product is gone but in reality, the inflammation has settled and you are able to see your final result. In my opinion, your physician was honest and would benefit from another syringe to achieve the result you wish for

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews


Every person is different when it comes to fillers. Initially, your clinician may have tried to be conservative in your treatment. If lines are deep, you will likely need multiple syringes. It's important to communicate expectations with your clinician so as to not be disappointed. Radiesse is much more viscous (thicker and volume building) than hyaluronic acid products, such as the Restylane and Perlane you mentioned. If you are looking for volume, Radiesse is your best option. Best of luck!

George T. Boris, MD, FRCS, FACS
Los Angeles Facial Plastic Surgeon
3.7 out of 5 stars 18 reviews

No Improvement After Initial Radiesse Injections?

You should have at least another syringe injected...Cheeks require more volume than most people anticipate and that usually means at least a full syringe (1.5cc) on each side.  Possibly even more, although I usually prefer to stage the injections (ie, not more than two syringes at one visit) if at all possible.  I think that the HA's are too thin for maintaining cheek volume so I'd recommend that you stay with the Radiesse, but have another (full) syringe injected.

I hope that this helps and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Flat cheeks usually require two or more syringes of Radiesse

The cheeks require more volume than you think and unfortunately one syringe may only give you a mild or subtle improvement. Your plastic surgeon had already estimated that you would need more than one syringe and planned that by suggesting you come back in one month for additional injections. Stick with your surgeon and return for additional injections.

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

No Improvement After Initial Radiesse Injections?

 No, Restyalne is too thin for facial shaping.  Perlane is thick enough and is my filler of choice for Cheek Augmentation however without photos of your face (non-smiling) there's no way for me to evaluate the shape of your cheeks.  You may have a change in the cheeks after the Radiesse but it might not be in the proper position to craete an angular, more masculine shaped cheek.  If that's the case, more is certainly not the answer since Radiesse can last uo a year and can not be dissolved.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Flat Cheeks

Hi Beach Bum 2222. Your Plastic Surgeon sounds like he or she has a plan in place for you. Stacking fillers is a great way to go.  The filler will build upon itself to plump your cheeks. Perhaps you can them a call if you are worried, or disappointed and see what your Plastic Surgeon suggests for you.

Christine Rodgers, MD
Denver Plastic Surgeon
4.9 out of 5 stars 90 reviews

No Improvement After Initial Radiesse Injections

What your PS has suggested is often referred to as "stacking" fillers. This allows an injector to put some in, and then have you return a few weeks later, to add more. It seems he knew and told you upfront that one syringe was not going to be enough and that you wouldn't see much from the single round. But by stacking the fillers, it actually makes them last longer and can be ideal for less swelling and bruising too. Perlane or Restylane are not going to do anything different than simply putting in more Radiesse. Plus, the advantage of Radiesse is that it's really a good filler for building upper cheeks.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

No Result after Radiesse?

Hi BB.  If your cheeks were quite flat, we would have probably recommended 1.5 CC's in each cheek or even Sculptra injections.  If your injector only did 1 syringe of Radiesse at the first visit, this would very likely not be enough to see a visible change.

Two other issues.  Before and after pictures should have been taken so that you can see the difference and swelling does occur after injections and when it goes down patients often tell us they think it looks like they have not had much product.  This usually occurs when the patient has not taken our recommendation for how much product they need.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Flat cheeks not improved with just need more

Radiesse is a filler that you don't want to do too much in one treatment in the upper cheeks.  Waiting a month for putting more in is appropriate.  I don't think that the other fillers are any better than Radiesse for the cheeks so I would go with the game plan your PS has laid out.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

No change noticed after Radiesse injection to cheeks

The most common reason for not seeing any noticeable improvement after injection of Radiesse would be due to not having enough injected.  I would say that you should go back and have more placed and this should improve your appearance.  While you could have Restylane or Perlane placed, these would not last as long as Radiesse.  Sculptra or Artefill could give you longer lasting results than Radiesse.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.