Should patients be told there is a risk of hard white lumps under the skin when Evolence is administered? I don’t think people would take the risk, bearing in mind that one could be left with these for 12 months or longer. At least with other temp fillers if one gets lumps, they only last 3 months. Should this be brought to the attention of the patient?
Should Patients Be Warned of Evolence Side Effects?
Doctor Answers 1
Evolence superior in less swelling and bruising but requires an experienced physician injector
Subcutaneous lumps associated with Evolence as in the case with all other fillers have to do with the experience and artistic skills of the physician injector. Evolence involves relatively advanced technique and should be done by an experienced board-certified dermatologist or plastic surgeon.
The key is for the physician injector to massage with some vigor after each injection and for the injection to be placed in the mid-to-lower dermal layers of the skin. Most physician injectors are reluctant to massage with vigor after hyaluronic acid (HA) fillers such as Restylane or Juvederm injections to minimize swelling due to the fact that hyaluronic acids fillers are humectant and draw water to the area with further massage or manipulation. Therefore, when a less refined injector performs Evolence injection utilizing old techniques learned from prior Restylane or Juvederm experience, one may come across subcutaneous lumps.
The advantage of Evolence is much less swelling and bruising, slower and more gradual degradation of the filler material, and greater longevity compared with hyaluronic acid fillers such as Restylane or Juvederm.