Radiesse injections. Hit blood vessel? (Photo)

Question

Two days ago I had Radiesse injections around the eye area. Toward the end of the injections, the practitioner said she hit a blood vessel and stopped all further injections. She told me to keep ice on the area for 48 hours. This is what the area looks like now. Is this to be expected? Is there anything I should be looking for as far as complications? (my provider is very responsive and I will send her photos tomorrow. Just thought it wouldn't hurt to get other opinions.)

Julia Ann Sullivan Miller, MD · Answer

It does appear that the injector hit a blood vessel around your eye which resulted in this bruising.  This is a risk when injecting in the thin and highly vascular skin around the eye.  The bruising should resolve in 7-10 days.  Please follow up with your doctor

Raffy Karamanoukian, MD, FACS · Answer

Radiesse is a stimulatory filler that is an excellent option for patients who desire a longer-lasting filler alternative to hyaluronic acid dermal fillers. In our office, we use Radiesse to complement structural areas of the face and contour bony prominences. Our office also is a center of excellence for filler complication treatments and we see patients who have been treated by other doctors and have undesirable results from Radiesse or other long-lasting fillers. We have treatment options available for Radiesse filler nodules, granulomas, and soft tissue thickening. The first step would be to diagnose the nodularity and determine whether there is an option for surgical vs. non-surgical removal. Surgical excision is a possibility in some patients; whereas others with more diffuse fillers may benefit from intralesional therapy using scar modulators and enzymes and kenalog. Radiesse complications may be long-lasting and prompt action is key. Patients who have no access to an expert in the field should begin gentle massage of the areas of nodularity with Plato’s Scar Serum twice daily. RF and invasive lasers can actually do more damage by stimulating further collagen growth. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Steven F. Weiner, MD · Answer

This can happen, especially when using needles around the eye area. Even though it can happen with cannulas too, it is much less likely. At this point, you can use a vascular laser such as VBeam or Excel V to reduce the duration to 3-4 days. Arnica orally can help as well.

Jeffrey M. Hartog, DMD, MD · Answer

Unfortunately it is possible with any injection to hit one of the small blood vessels under the skin, whether it's Radiesse, Botox, Juvederm etc. We do try to avoid it but it will happen to every injector from time to time. This results in some bleeding under the skin and bruising, as you have experienced. This is not usually something to be concerned about, and just like any bruise anywhere on your body, will resolve with time. It's an inconvenience of course because of the appearance, but nothing to be worried about from a medical standpoint. Medications like Arnica may help the bruising fade faster. You can also use makeup over the bruise. For the first 2-3 days icing can help if there is any swelling. Also avoid medications like aspirin and ibuprofen as these make small vessels bleed more.Fortunately no Radiesse was injected into any blood vessels, as this can result in more significant injury to related tissues etc, and this is an extremely rare complication with any of the injectable fillers. My preference is to avoid injectables like Radiesse any more, as Radiesse cannot be dissolved once injected like the hyaluronic acid fillers. (Juvederm, Restylane, Volume etc.)

Radiesse injections. Hit blood vessel? (Photo)

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