Virginia Beach Hyaluronidase doctors

I share Dr. Ruecki's skepticism that Restylane would still be present five years after injection. Though rare this could possibly be a granuloma. Hyalruonic acid fillers have been known to elicit a granuloma, some time after injection. Another possibility, as Dr. Ruecki states, is that something else besides Restylane was injected; silicone for instance. That is why it is important, in this day of Chinese knock-offs, that patients request an examination of the box from which the syringe was withdrawn. In the case of Restylane there is a shiny sticker on one end. The third possibility is that the lump due to a ruptured cyst, lipoma or other benign tumor. This may or may not have been induced by the injection process.

My suggestion would be for your dermatologist ( or plastic surgeon), perform a 2 mm. punch biopsy of the lump. The pathologist should then guide the ensuing treatment. If a granuloma, a well placed steroid injection. If a ruptured cyst: excision or steroid injection. Lipoma: excision. If it is silicone: removal. 

Good luck.

You certainly are experiencing the downside of a permanent filler.

Unfortunately, hyaluronidase, an enzyme ( enzymes end with the letters ase) will only break up hyaluronic acid. It will have no real effect on silicone. Most likely, the silicone will have to be extracted surgically.

An injection granuloma occurs when a medication is inadvertently injected into the fat rather than the muscle. This causes fat necrosis (fat death), scar formation, and sometimes calcium deposits. If the patient can not recall receiving an injection, these can feel like a soft tissue mass and occasionally lead to an erroneous diagnosis of sarcoma.

Even under the microscope, this can be a tricky diagnosis. I remember as a pathology resident, this can pose a very difficult call in evaluating a breast mass...that tissue being a fairly common area for fat necrosis.

It is felt that women develop more of these injection granulomas due to the larger amount of subcutaneous fat. There may be a hormonal reason for this also.

Decreased blood flow (hypovolemia), also makes one more prone to an injection granuloma. The fact that you were in anaphylaxis (to what?) made you more susceptible to an injection granuloma.

It may be best treated with judicious, dilute corticosteroid. Your physician must be careful since steroids too can cause granulomas. However, they do often break them up, hence their use in this situation.

Otherwise, they can be excised by a surgeon.

By the way, send a thank you note to the person who handled your emergency each of your birthdays!