Radiesse in Cheeks and Tear Troughs: Do I Need a Touch-Up?

I got my cheeks done with radiesse and loved it. It caused my already bad tear troughs to look worse, so I got them done too. Now I am on the fence: now that I got a little more in my cheeks I think i need my tear troughs re-done or touched up, but I don't want to look like Kim Kardashians been looking lately-with no line of demarcation between her eyes and her cheeks. What should I do?

Doctor Answers 12

Radiesse and cheek filling vs tear trough correction

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Your photographs do not provide enough information to create useful advice.  The smile in the one photograph pushes up against the eyelid muscle and creates rolls of skin and muscle of the lower eyelid.  The flat appearance of the other photograph shows a different lower eyelid contour.  If the tear trough is still needed to be corrected, Restylane is a great filler when used underneath the muscle in this area.  Radiesse is great for the cheeks.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Restylane in the Tear Troughs

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Your result does look fine and there is only a faint shadow remaining in the tear troughs. Restylane comes in smaller, half sized syringes which, in my office, are close to half the price and would be easy to use for a touch up if you desired.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Radiesse not for tear troughs

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The one great thing about filler is that it produces great improvements and the downside is it makes you notice other issues in your face. I would recommend Restylane for the tear troughs. Like many patients, you have some facial asymmetry and may benefit from additional filler in the right cheek. Depending on when you were injected, you can plan additional treatment with your physician.

Restylane NOT Radiesse for Under Eyes...

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Go for a more natural look!  Do not try to look "perfect".  Radiesse is excellent choice for cheek volumization, NOT  for treating the tear troughs!!!  If you wish to have a little more injected under your eyes I would recommend you get Restylane -ONLY!  It is safer and gives better results. 

Hope this helps.

 Dr. Grant Stevens       

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

Radiesse /Fillers

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   When considering to have more product injected, it is always best to error on the side of being conservative with the amount that you are having placed. It sounds as though the Radiesse in your cheeks has given you good results. Be careful when having filler placed into the tear trough area. It is better to go with a filler like Juvederm or Restylane in the under eye space. Radiesse can appear opaque under the skin, since the tissue is much thinner in the tear trough area and there is a chance it can migrate, creating a bead appearance.

Joseph Serota, MD
Aurora Plastic Surgeon

Facial fillers

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Reviewing your photos it appears as if you have an improvement from the Radiesse

The issue is whether to accept the good improvement you already have or try to make it better

It becomes a personal decision

I agree with the other physicians who mentioned that if you try to obtain a further improvement in the tear trough region, for this type of "touch up" I favor Restylane, which is a hyaluronic acid gel

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Cheeks usually need to be raised to efface tear troughs.

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Cheeks usually need to be raised to efface tear troughs. Filler impalntation in the ceeks is usually best done at the level of the cheek bone and may be pushed superior to the bony margin.

Edward Lack, MD
Chicago Dermatologist

How to determine if it's time for a Radiesse touch up

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I will start by saying I do not recommend Radiesse in tear troughs.  Radiesse is a great filler/biostimulator but has been known to cause more side effects in tear troughs and lips and should not be used in those areas. 

In my opinion, Restylane is the best filler for tear troughs.

As to when it's time to do a touch up, if you are happy with your look, then wait 2-3 more months and see how things go.  The problem with Radiesse is that if too much is injected, there is nothing to do other than wait for it to dissolve a year from then.

As for a line of demarcation between tear trough and cheek, in young faces there usually is not a line like that present, but it does depend totally on what you prefer.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Touch-up after Cheek and Tear Trough Augmentation

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Remember, perfection can be our worst enemy. If you're hesitating, it means you're satisfied and I suggest you do nothing more at this time. Radiesse is temporary; as the improvement declines you will continue to re-evaluate your appearance and have a touch-up when necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Radiesse could be used to make Right cheek fuller

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 Radiesse could be used to make the right cheek more full and round.  Radiesse should not be used in the thin skin area of the tear trough as it's meant to be injected into fatty tissue which this area has none.  Use Restylane or Juvederm there as they are much thinner and won't create lumps and bumps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.