Dear Dr. Seckel, Approximately five months ago, I accepted the recommendation of a (board certified, reputable) plastic surgeon to use Radiesse® to correct an extremely minor concavity in my naso-jugal folds (dark circles under the eyes). I accept responsibility for the disastrous result because I failed to research the product before I agreed to this procedure. As you may know, Bio-Form does not recommend that this product be used for this purpose because they are receiving reports that it can exacerbate the problem rather than resolve it. Like many other unfortunate people — as I am coming to learn from my research — I have been left with huge bags beneath my eyes that are bright red and purple in color. My surgeon agrees that I have been “significantly disfigured” by this injection, but he claims there is no remedy for the dilemma except to wait for the material to dissolve in two years. He has been training other physicians in the use of since it was first developed and states that he has never seen as terrible a result as this. I am 35, and while I do not suffer from skin laxity, my surgeon concurs with my estimate that my lower eyelid tissue has been so dramatically stretched that it will require excision when the material finally dissolves. In the meantime, I am wearing dark glasses all day, every day because it is not uncommon for people to gasp aloud when they see me and because I myself cannot bear even accidental encounters with my own reflection. I am sure that others who read your blog find themselves in a similar situation. Is there any procedure that you can recommend to us to repair this kind of damage? My primary care physician has suggested that I consult another plastic surgeon about the possibility of a blepharoplasty, since my own tissue has, by now, built around the material that was injected. Honestly, after my recent experience, I have been frightened that another plastic surgeon might only make my predicament worse. You are renowned for your expertise with blepharoplasty, so your opinion would be most valuable. Would you recommend a blepharoplasty, or another procedure, to those of us who are suffering from this kind of damage? Thank you for any guidance you are able to offer, Dr. Seckel, Sincerely, Jamie, New York, NY
Dear Jamie,
I am terribly sorry to hear of your unfortunate experience. Unfortunately board certification in Plastic Surgery is no guarantee. This emphasizes the importance of consumer education and is what I am trying to achieve with this blog and my book Save Your Face. Hopefully others will learn from your misfortune and be able to avoid what has happened to you. As you now know I have been writing for some time that I believe filler injections around the eyes are dangerous and should be avoided.
It would help me to give you a better opinion about the advisability of a blepharoplasty if you could send me a digital photo of a front and side view of your eyes which demonstrates the effect of the Radiesse® injection on your eyelids.
The hopeful thing about your situation is that the soft tissue filler Radiesse® will eventually dissolve. I do not think it will take 2 years. I do believe the Radiesse® will be substantially lessened by 6 months and mostly gone by 9-12 months.
I am not comfortable with doing any intervention at this point to remove soft tissue filler material-steroid injections, Hyaluronidase enzyme injections, or other intervention at this point will potentially make things worse.
Surgical intervention in the form of a blepharoplasty may eventually be an option but I need to see your photos. The safest way to remove soft tissue filler material during a blepharoplasty would be the transconjunctival laser blepharoplasty approach removing the material from underneath the eyelid, however this would not address the issue of the swollen stretched eyelid skin.
Therefore, if, after an acceptable time interval waiting for the filler material to dissolve and the skin to tighten, surgical intervention is deemed necessary, some form of external incision may be required. This could either be a direct excision of the excess skin and residual Radiesse®, which would leave a scar at the bottom of the lower eyelid, or possible a standard lower blepharoplasty through an incision under the eyelashes modified to remove any residual Radiesse®.
These are very complex surgical decisions and need to be thought through carefully and I would need to see and examine you personally before making a recommendation. The major concern in addition to external scarring is the possibility of ectropion or change in eyelid shape that could occur with any external approach to removing the Radiesse®.
The good thing and the most important thing for you to focus on now is that you will improve with time. I know it is very difficult for you, but I caution you about pushing for intervention at this point in time. You will improve and hopefully not require surgical intervention.
Have you contacted Bio-Form-they need to be informed of your experience? Radiesse® is an excellent product, when used appropriately, I use it almost exclusively for the Naso-labial fold. An experience like this needs to be brought to their attention.
For now I recommend massaging the palpable Radiesse® with your finger several times a day. In my experience massage will speed the dissolution of the product.
I would be happy to review your photos confidentially if you wish to send them.
For more information on fillers, blepharoplasty and non-surgical facial rejuvenation read Save Your Face or contact me.
Sincerely,
Boston, Massachusetts