How can I get rid of cosmetic injection lumps from six years ago?

Although you think it was a hyaluronic acid product it may have not been.  If it was, then it should have dissolved unless it was extremely superficial and in that case a small incision with a needle can express the product. If it was a granulomatous reaction to product, then the only way to get rid of it would be excision. All other permanent type products like Artefill or silicone can only be removed by excision.

Silicone injections can contribute to long term inflammatory reactions that can cause disfiguring nodules and lumps subcutaneously. The lumps and nodules should be treated accordingly with anti-inflammatory medications that reduce the inflammation and edema surrounding the foreign bodies. These can be applied subcutaneously, or topically depending upon the zone of inflammation.

Atrophy can be induced if the subcutaneous injection of corticosteroids are not performed by an experienced physician. A silicone protocol should be employed to minimize the risks associated with this procedure.

Six years ago, the only FDA approved products in the US were collagen based.  These products were Zyderm, Zyplast, Cosmoderm, Cosmoplast and a now discontinued product called Dermalogen.  While these could have caused lumps, it is extremely unlikely that they would cause such lumps like you are describing.

Sadly, you were probably injected with Silicone, which is NOT approved and has never been approved for facial injections.  This is the reason to only have FDA-approved material injected into your face and, furthermore, to avoid anything that promotes itself as permanent or semi-permanent. 

Ones to avoid now that are, indeed, FDA approved are Artefill and Sculptra.  These can cause some very concerning problems.  Others that are undecided/jury out are Radiesse and Evolence.  While you can certainly have them done, they don't have the track record yet of Restylane, Perlane and Juvederm. 

You need to get a second opinion from a dermatologist in your area with a good reputation.

You might consider having one small area sent to a dermatopathologist after having a small biopsy. Perhaps under the microscope he/she could determine what is causing this. It is unlikely to be a hyaluronic acid filler acting like this...

Hi Say,

If it truly was hyaluronic acid that was injected, then it should be superficial in the skin.  A small puncture with a #18 gauge needle and pressure should be able to squeeze the material out (I have seen this in a few patients after a year).  Do not attempt this yourself, have a trained physician evaluate the situation.  In Chicago, I might visit Steven Dayan, MD.  Good luck and be well.

Dr. P