Radiesse lumps in tear troughs

I wanted Radiesse in my cheekbone area but for some unknown reason my PS injected into my tear trough area which was smooth and wrinkle free that is until after he rined my under eye area with the Radiesse. The Radiesse formed lumps and created an uneven crinkly look under my eyes. It makes me look about 10 to 15 years older than my true age. It also caused deep red circles as well where I previously did not have any discoloring under my eyes. The procedure was done Dec 15th 2008 and I am still dealing with the aged under look of lumpiness and crinkling. My PS has injected saline, done 3 IPL treatments for the redness and so far 1 pixel treatment to try and disguise the lumps and crinkling by tightening the under eye tissue. All have had limited results. My question is in your experience does the Radiesse resolve completely, or will this cause permanent damage to the delicate under eye tissue and I will have to resolve myself to looking 10 to 15 years older than my true age? Before the Radiesse I looked 10 to 15 years younger than my true age so it is very distressing to appear looking 20 to 30 years older overnight. It seems to have destroyed the integrity of my skin in that area. Help?

[Howard Rosenberg, MD]

When I do inject tear trough areas, I typically use hyaluronic acids like Restylane or Juvederm.  If the injections of hyaluronic acids are dislsiked by the patient, I potentially can dissolve that materila with injection of hylauronidase - not so for Radiesse.  Unlike the nasolabial folds,where the injectables last about four months, the tear trough injections often last up to one year.  Radiesse lasts longer than the hyaluronic acids, and so while the Radiesse will last up to seven or more months in the nasolabial folds, I suspect that the Radiesse will last even long than one year in the tear trough area, but will ultimately resolve (although I have no experience with Radiesse in that area).