Bulky with nodules. Will Radiesse in the chin ever go away? (Photos)

Question

I made the awful decision of allowing a nurse injector talk me into getting radiese in my chin and jaw. I am extremely bulky and I’ve had some nodules. The volume and projection has looked awful. I’m about seven months out and have done some saline which has helped. I’m reading that there’s a possibility I will never go back to baseline and will have enlarge tissue. I’m trying to see if I need surgical intervention or will my chin go back down I am 26 and Work work out frequently and live a healthy lifestyle

Anna Chacon, MD, FAAD · Answer

I’m sorry you’re dealing with this, especially when the results are so different from what you wanted. I understand how distressing it can be to feel that your facial shape has changed in a way that doesn’t look or feel like you.

Radiesse is a calcium hydroxylapatite (CaHA) filler. Unlike hyaluronic acid fillers, it cannot be dissolved with hyaluronidase, and its breakdown can be gradual and unpredictable. At seven months, some of the original filler may still be present, and the collagen stimulation it produces can also contribute to the appearance of fullness. In some cases, nodules or persistent swelling can make the area look bulkier than expected. However, this does not automatically mean the changes will be permanent or that you will develop irreversible tissue enlargement.

Saline injections are sometimes discussed as a way to address unwanted filler, but evidence supporting their effectiveness for Radiesse is limited. I would be cautious about continuing injections without first determining what is causing the bulkiness and nodules.

The next step is an in-person assessment by a board-certified dermatologist or plastic surgeon experienced in managing filler complications. High-frequency ultrasound can sometimes help identify the location and nature of the injected material and distinguish it from surrounding tissue changes. Treatment depends on the findings and may involve observation, targeted treatment for inflammation or nodules when indicated, or, in selected cases, a surgical approach. Surgery is not necessarily the first or only option.

Because you have persistent nodules and an unwanted change in your chin and jawline, I would not recommend simply waiting indefinitely without having the area evaluated. Seek prompt medical attention if you develop increasing pain, redness, warmth, drainage, or rapidly worsening swelling.

At 26, there may still be options to improve the appearance, but the safest plan is to establish exactly what is causing the fullness before pursuing further treatment. Your healthy lifestyle and exercise routine are beneficial overall, but they do not reliably determine how quickly Radiesse or the tissue response to it will resolve.

Nelson Lee Novick, MD · Answer

I'm so sorry you are having this problem. For reasons such as yours, I have not recommended the use of Radiesse for many years, especially when later versions of more robust hyaluronic acid fillers were giving longer-lasting results than earlier versions, reducing the advantage that Radiesse offered in longer-lasting results.
I have personally achieved gratifying results in persons who have come to me with similar problems following treatment elsewhere using varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Bulky with nodules. Will Radiesse in the chin ever go away? (Photos)

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