Collagen reduction - any way to get rid of excess collagen bulk?

Question

Hi I want to reduce the collagen bulk that I have on my lower face post radiesse. Any way to get rid of excess collagen bulk?

Anna Chacon, MD, FAAD · Answer

Yes, but it depends on what is actually causing the fullness. Radiesse is different from hyaluronic acid fillers because it stimulates your own collagen production. Once that collagen has formed, there isn't an enzyme that can simply dissolve it the way hyaluronidase dissolves hyaluronic acid fillers.

If the fullness is truly due to excess collagen, there are a few options that may help over time:

Patience: Collagen remodeling is an ongoing process. The firmness or bulk often softens gradually over several months as the tissue naturally remodels.
Intralesional corticosteroid injections (such as triamcinolone): In carefully selected cases, these may help reduce localized fibrotic tissue or nodules, but they must be used cautiously in the face because excessive treatment can lead to skin thinning or indentations.
Energy-based treatments: Radiofrequency or focused ultrasound may help remodel collagen in some cases, although evidence specifically for reducing Radiesse-induced collagen bulk is limited and results can vary.
Surgical removal: This is generally reserved for persistent, well-defined nodules or significant contour irregularities that do not improve with conservative management.

It's also important to determine whether the fullness is actually from new collagen, residual Radiesse product, scar tissue, or simply the natural contour created by the injection. These can feel very similar but are managed differently.

If the treatment was relatively recent, I would avoid rushing into corrective procedures, as the appearance often improves as the tissues continue to remodel. If the area has remained unchanged for many months and is bothersome, a careful evaluation can help determine which of these possibilities is most likely and guide the safest next step.

While there is no medication that specifically "removes" excess collagen from Radiesse, there are treatment options that may improve the contour once the underlying cause has been identified.

Nelson Lee Novick, MD · Answer

Treating unwanted Radiesse issues, much like those with Sculptra or with any of the permanent fillers, can be difficult. Fortunately, I have had gratifying results using an algorithm of intralesional injections of varying combinations, concentrations and amounts of anti-inflammatory agents. You would be wise to consult with an experienced, board certified cosmetic dermatologist. Best of luck.

Collagen reduction - any way to get rid of excess collagen bulk?

Answers (2)

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