Restylane does not cause bumps under the skin...

Restylane does not cause bumps under the skin unless:

1. It is injected too superficially
2. It is injected unevenly

Skin reactions or prolonged inflammation related to the injection of Restylane are extremely rare (I, personally, have never seen it). Areas where the skin is thicker, such as the nasolabial folds, are much less likely to end up with bumps, compared with areas where the skin is very thin, such as the tear troughs below the medial lower eyelids.

I recommend that patients do nothing other than gently apply ice to areas injected with fillers, including Restylane, for the first 3 days following their treatment. This allows for most of the initial swelling to resolve.

After the 3rd day and before the 7th day post-injection, I recommend massaging any area with a visible bump, excess fullness, or asymmetry, several times a day, until it smooths out. This massage can be performed with a fingertip or the tip of a Q-tip.

Patients should recognize that injected fillers may be palpable for several months, however, only visible lumps or bumps are of concern. It would certainly be a mistake to massage an injected filler out of the area that it was meant to fill.

The good news, in case of a Restylane or Juvederm bump that fails to resolve in a timely fashion, is that these materials (hyaluronic acid gels) can easily be dissolved with the injection of hyaluronidase (Amphadase or Vitrase).

Bumps composed of other injectables, such as Radiesse or Artefill, are more difficult to treat. Injection of steroids along with vigorous massage would be a good first step. Surgical excision is rarely, but sometimes required as a last resort.

Thank you for your question.

Injection technique is primarily responsible for bumps after treatment. While this is injector-dependent, you can also do things to reduce bumps. The main post-injection practices that you can do are gentle and repeated massage, and ice application to minimize swelling. You only have  a 1-2 day window of massaging to move the Restylane around and minimize the bumps.

If you notice a "blue bump" in the skin that does not improve after massaging, that may represent restylane injected too high in the skin. To correct this, your physician can inject a little hyaluronidase or make a little nick in the skin to remove the Restylane. Otherwise, you might have to wait approximately 8 months or longer for it to be resorbed.

Hope this helps! 

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If you feel bumpiness after Restylane, it is likely that you have a small concentration of product around an injection site. When this occurs, it is possible to massage the area to smooth out the bumps, although this procedure is something we like to avoid as it may lead to shorter duration for the product if too much massage is necessary.

To avoid bumps, make sure to choose a practitioner carefully.  If the injections are done with the proper care, you should not have much bumpiness at all.  In a last resort scenario, your practitioner can use Hyaluronidase to reverse the effects of the Restylane if severe bumpiness is present.

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