Could a granuloma in my cheek from Radiesse maybe a year ago dissolve on its own?

Question

I had Radiesse injected in the hollows of my cheeks about a year ago, as well as a place on my chin. Last January my doctor had to incise the granuloma on my chin which left a scar, and he's still carefully injecting steroid in that area to break up the scar tissue. I've developed a larger granuloma in my cheek that didn't respond to the 1st steroid shot. It would leave a bad scar to excise. What can be done?

Jon M. Grazer, MD, MPH, FACS · Answer

It is unlikely that you have granulomas from Radiesse injections. Granuloms are a foreign body reaction. What you most likely have is a nodule from over injection of a filler in one area. Nodularity of stimulatory filler such as Radiesse and Sculptra are most frequently seen in the lips and around the eyes, that is why these filler are not ideal in these areas.When a nodule is formed from over injection of Radiesse it is unnecessary to to inject kenalog or the excise it. Over aggressive injection of kenalog can cause atrophy of the underlying tissue and cause a depression and excision can cause a scar.The Radiess nodule can be injected with with lidocaine to numb the area, and firm finger massage can break up the nodule. Typically the nodule will  slowly resolve after this, and the procedure can be repeated at three week intervals. Usually only one to two treatment is all that is necessary, but it depends on the size of the nodule. If there is a contour deformity from residual filler as it absorbs, the area can be camouflaged with hyaulronic acid fillers.Refer the referenced article for details of the procedure. Dispersion of Calcium Hydroxylapatite Accumulations in the Skin: Animal Studies and Clinical Practices.Dermatological Surgery    (Impact Factor: 1.87).   04/2010; 36(s1):798 - 803.   DOI: 10.1111/j.1524-4725.2010.01567.xYours,Jon M. Grazer, MD, MPH, FACS

Raffy Karamanoukian, MD, FACS · Answer

Our office specializes in filler complications. You may consider conservative treatments to help dissipate the granuloma. We would also recommend massaging the area with Plato's Scar Serum. Best, Dr. KaramanoukianSanta Monica

Vivek Bansal, MD · Answer

Thank you for your question. An excision may be your best bet.  The cheeks typically heal well.  Have a Board Certified Plastic Surgeon remove the granuloma, and do a cosmetic closure, and laser it in about a year.  The scars are usually very small at that point. I hope this helps!

Jason Emer, MD · Answer

The only permanent treatment for granulomas is surgery or #11 blade excision and removal.  Id suggest trying low dose steroid with 5-FU for a better improvement, with subscision of the area.  If this doesn't work, I add in fractional laser (fraxel) and/or radiofrequency treatments such as Sublative and I have found this work many times in patients sent to me for revision of complications.  Best, Dr. Emer.

Could a granuloma in my cheek from Radiesse maybe a year ago dissolve on its own?

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