Are Granulomas Really a Problem?

asked 4 months ago by VCT
Latest answer by Julio Garcia, MD
Question viewed 145 times
Tags: nasolabial folds, 8 months post-op, granuloma

A very well known dermatologist whose injections of Restylane provoqued bumps and one large nodule in and around the nasolabial fold (slowly disappearing after eight months), told me the following logic: Granulomas do not matter at all as long as you do not remark them, that he has many patients with bumps who continue with hyaloronic acid injections. The only point is that the material has to be injected very deep to people who react so sensitively to avoid negative cosmetic results.

6 answers to Are Granulomas Really a Problem?

Granulomas

Granulomas are rare with hyaluronic acid fillers such as Restylane, injecting deeper would not prevent a granuloma if it was going to form, it would only make it more difficult to feel or see.

Julio Garcia, MD
Las Vegas Plastic Surgeon

Granulomas.... NOT with Restylane...

I completely agree with the other physicians! This is completely wrong. I have never heard nor experienced granulomas with Restylane injections. Hope this helps. Good luck. Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon

Granulomas are highly unlikely with Restylane

I have been injecting Restylane for many years (as long as it has been on the market in the US) and I have never either seen or heard of granuloma formation from this product. Restylane is a hyaluronic acid product and has no organ or species specificity. In theory there is no risk of an allergic reaction. In fact, in spite of its frequent use for cosmetic purposes, there are very few reports of hypersensitivity reactions. I suspect lumps like you are describing are all "technique... more

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

This is a ridiculous statement.

In fairness perhaps you misunderstood what your doctor was trying to say. It is important to distinguish between lumps from too much material deposited in a given spot and an actual granuloma which is an inflammatory nodule. Actual granulomas represent an inflammatory response and is associated with tenderness and focal swelling. These are not welcome events and are uncomfortable. The hyaluronic acid fillers are not dependent on inflammation for their filler effect.... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Restylane granuloma?

I agree with Dr. Aldea. I have never had a case of granuloma after Restylane injection. Some of the thicker fillers, such as Radiesse, Perlane or Sculptra are more prone to this complication. I also would not recommend injecting anyone in the area of a "bump" as this will make its appearance more pronounced.

Robert L. Kraft, MD
New York Plastic Surgeon

Granuomas and Wrinkle Filles

A Granuomas is a chronic inflammatory reaction which may be seen with any long-lasting foreign body recognized as such by the body. This can include stitches and some fillers. I have used Restylane ever nice it was FDA approved years ago and have never entered a case of Granuoma with it. Such complications are a lot mor common with other filles such s Sculptra. Personally speaking fillers associated with a high rate of Granuomas are problematic but potentially relying on the fullness... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

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