Is there anything that can be done for Radiesse that has been injected too superficially aside from massage? (Photo)

Question

I could tell that the injector wasn’t putting the normal amount of pressure to get close to the bone. The injector claimed that I already had product in there and that she had to go on top of it, but in the past I feel like they’ve always gone through it to get close to the bone. The result on my chin is little white nodules that can be seen just beneath the skin surface. Is there anything that can be done to dissolve or smooth the product?

Raffy Karamanoukian, MD, FACS · Answer

Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

this can be improved with plasma pen or needle desiccation and lasers, at home dermarolling with peels like cosmelan can be used (see link).  in office 5fu/steroid/hyaluronidase can be used.  Id suggest spot treatment with lasers like halo/fraxel/moxi and at home enlighten or cosmelan now.  Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

Despite the fact that Radiesse is not a hyaluronic acid-based product, hyaluronidase has been recommended for prompting or promoting its breakdown. Although I stopped injecting Radiesse (with its attendant concerns about lack of reversibility)  a number of years ago when more robust and longer-lasting hyaluronic acid products became commercially available, I have quite a number of times personally used hyaluronidase along with subcision with very gratifying results to physically break up the mass of calcium product in patients with unwanted aesthetic outcomes or adverse reactions to Radiesse who have come to me following treatment with Radiesse received elsewhere. In your case the white nodules appear so superficial that your doctor might wish to nick the surface of the nodule and physically extrude the little ball of Radiesse calcium.  I hope this helps. Best of luck.

Dmitriy Schwarzburg, MD · Answer

Hyaluronidase is not meant to dissolve radiesse. There might be other ways to promote it or have it removed completely by other means. Consult with your doctor to get a complete assessment.

Is there anything that can be done for Radiesse that has been injected too superficially aside from massage? (Photo)

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