Radiesse Injection in the Nasolabial Folds

Hi Dr. Rivkin,

Is it possible for Radiesse to migrate a little? I have had Radiesse several times in naso-labial folds. Despite multiple injections in the upper part of the folds (lateral to the nares--I think some injectors refer to the area as triangles?), after initially looking corrected, that part of the fold seems to always show up again within a couple days to a week. I would have thought it was just the swelling going down and that I needed more filler, but I think I've had more than enough in that area to fill the folds over the last 2 months (I went back for more 3x's). When I've noticed the folds coming back I've wondered if the material moved to the ridge that's just above the fold making it all look worse. So I've tried to smooth/push it back down to the fold area which seems to actually work, but just temporarily. This problem doesn't seem to occur in the lower part of the fold that's injected.

Any thoughts?
Thanks!


hi,
what you are describing is really common.
you have to make sure that the person you are going to is experienced injecting radiesse because this is what happens when you put too much radiesse into the triangle area. unfortunately, there is a difference between a fold and a wrinkle. its easy to fill in wrinkles - more difficult to fill in folds. it may be that the skin in that triangle area will never lift up to where the fold is completely smoothed out. an experienced injector will stop before making the fold look worse by injecting too much in and having the material move above the fold. in this case, shooting for perfection may ruin a good result.
one solution if the area above the fold is visibly bigger is to inject steroids in there to bring it down. kenalog 10 should do just fine.
next time, i would consider using something like juvederm. you don't have to inject it quite as deep, so you will get more lift out of the skin. hope that helps