Radiesse extraction?

Question

I’ve had radiesse three times and it’s been several years, i now have chronic inflammation and scar tissue on the bone that I feel, I cannot make certain facial movements. I found a surgeon who wants to perform a lift on me. Can this be removed during surgery, it’s caused me extreme deformity and iam afraid it’s fibrosis and granulomas under the cheek bone. It’s also caused texture problems. Thanks

Anna Chacon, MD, FAAD · Answer

I'm sorry to hear about the difficulties you're experiencing. Radiesse (calcium hydroxylapatite) is a popular dermal filler, but complications such as chronic inflammation, fibrosis, granulomas, and textural changes can occur, although they are relatively rare. Here are some considerations and steps to discuss with your healthcare provider:

### 1. **Consultation with a Specialist:**
   - **Plastic Surgeon or Dermatologist:** Ensure that the surgeon you are consulting has extensive experience with dermal fillers and their complications. A second opinion from a dermatologist who specializes in cosmetic procedures might also be beneficial.
   
### 2. **Preoperative Evaluation:**
   - **Imaging Studies:** MRI or ultrasound can help determine the extent of the filler and associated tissue changes. This can provide a clearer picture of what needs to be addressed during surgery.
   - **Biopsy:** Depending on your symptoms, a biopsy might be necessary to confirm the presence of granulomas or other inflammatory reactions.

### 3. **Surgical Considerations:**
   - **Combination Approach:** During the lift procedure, the surgeon can attempt to remove or reduce the amount of Radiesse, as well as address any fibrosis and granulomas. However, this can be challenging and may not completely resolve all issues.
   - **Scar Tissue Management:** The surgeon should have a plan for managing scar tissue and fibrosis, which might involve meticulous dissection and possibly the use of adjunctive treatments to minimize scarring.
   
### 4. **Postoperative Care:**
   - **Anti-inflammatory Treatments:** Post-surgery, you may need treatments to manage inflammation. This could include corticosteroids or other anti-inflammatory medications.
   - **Physical Therapy:** Sometimes, physical therapy can help improve facial movements and reduce stiffness associated with scar tissue.
   - **Monitoring for Recurrence:** Regular follow-up is crucial to monitor for any recurrence of inflammation or other issues.

### 5. **Alternative Treatments:**
   - **Medical Management:** In some cases, before opting for surgery, medical treatments such as corticosteroid injections, 5-fluorouracil, or hyaluronidase (though not typically indicated for Radiesse) might be considered to manage inflammation and granulomas.
   - **Laser Therapy:** Certain types of laser treatments can help with skin texture issues and may reduce some of the visible deformities.

### 6. **Psychological Support:**
   - **Counseling:** Given the emotional impact of facial deformities and chronic pain, counseling or psychological support can be beneficial during this period.

It's important to have a detailed discussion with your surgeon.

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