Restylane Lumps Can be Managed Successfully Using Combination Therapy

Raffy Karamanoukian, MD answers: How long before Restylane bumps in tear troughs go away?

I had Restylane injected in my tear troughs 9 months ago. After I had it done, you could see a little bluish mark under each eye where it had been injected and what looks like half moon ridges there under my eyes as well. There were hard bumps on each side of my eyes as well that I was told to massage with a hot cloth very hard.

The bumps, I thought, went away but recently I can notice them again and they are very hard and the ridges and bluish marks under my eyes never went away.

I am very self-conscious and petrified to see someone, only to have it made worse. Will it ever go away? What should I do? Please help.


Raffy Karamanoukian, MD
10 months ago
By Raffy Karamanoukian, MD - Los Angeles Plastic Surgeon

Restylane can cause various temporary complications including lumps, contour irregularities, and a slight bluish hue underneath thin skin areas such as the tear trough.  Preprocedural assessment is crucial to avoiding or minimizing these complications.

A bluish skin hue may arise in cases where restylane has been injected under thin skin.  In these cases, the benefits of using a temporary filler such as Restylane come into play as the Restylane will slowly dissolve with time.  If the deformity is very evident, there are several notable treatments that can be performed, including the injection of TAC for granulomatous reactions, Hyaluronidase, and deep massage.

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A: Restylane

Brent Moelleken, MD
10 months ago
By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

Fortunately you have had Restylane rather than a semipermanent or permanent filler.  Restylane is a hyaluronic acid and should therefore go away entirely on its own.

In patients with very thin skin, filler can have a bluish hue to it.

Also, although much rarer, chronic bumps can develop.  This permanent lumpiness problem occurs much more frequently in permanent or semipermanent fillers.  However, the lifespan of Restylane around the eyes and even the cheeks is prolonged (up to one year) compared to when it is used in the nasolabial folds.

Hyaluronidase dissolves hyaluronic acid and would be a good choice for a problem that has persisted so long.

If you decide to do something about your eyes once your problem has resolved, you may want to consider a shorter acting hyaluronic acid such as Prevelle, which is easier to mold and has fewer swelling and lumpiness issues.  It may also "get you through" the lumpy phase which sometimes characterizes the last stages of hyaluronic acid fillers.

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