How Can I Get Rid of Cosmetic Injection Lumps from Six Years Ago?

I had a filler injection done six years ago. The doctor said it was hyaluronic acid. After a few months, visible lumps began to appear. I've had kenalog injected once or twice a year into the lumps. They flatten out a little for a couple of weeks and then come back. I'm trying not to get the lumps excised as it would leave a noticeable scar on my face. Are there any other solutions out there?

One of the doctors on your site suggested making a small incision and squeezing it out - will that work after all this time?

I tried hyalase injection but did not work either. One doctor I saw suggested more aggressive treatment of kenalog but I have concerns about skin atrophy as a result.

Please advise. I'm not sure what else I should do.

Asked 40 months ago by sayonara in Chicago
Sort 8 expert answers by:
+2

Say sayonara to your lumps

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
Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
+2

This one is tough!

I am so sorry that you have to go through this! It is a odd that the hyaluronic acid has lasted this long and has been refractory to hyalase injection. Perhaps as a result of the injection you have formed little cysts that respond to the coritsone injection but then return. I like the idea of acne surgery (incision and drainage) if possible. Are these bumps blue as would be with hyaluronic acids or skin colored as cysts?
Tanya  Kormeili, MD
Los Angeles Dermatologist
+1

Complications after cosmetic filler treatment

All good feedback from the panel members. As most suggested, it is highly unlikely that you were injected with a hyaluronic acid dermal filler. If you were, the product would not last this many years, it would have responded to hyaluronidase, and it would be a rare case wherein a body would respond with inflammatory nodules as yours has done with HA dermal fillers. On a sidenote, one panel member mentioned that, to avoid potential adverse reactions from steroid injections, you must have... more
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+1

Lumps after injection

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.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Anti-inflammatory medications for treating filler injection lumps

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... more
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
+1

Hyaluronic acid injectables were not available six years ago

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... more
Joel Schlessinger, MD
Omaha Dermatologist
+1

Perhaps you need a biopsy

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...
Evan Sorokin, MD
Cherry Hill Plastic Surgeon
+1

Probably not the HA anymore

You seem to have a very good grasp of the complexity of your situation. I would doubt that there is any hyaluronic acid left after 6 years and that the problems you are having are more from cysts under the skin. Excision of these, while leaving a small scar, is usually less conspicuous than the bumps themselves at conversational distance. It is also possible that what you had injected was actually not HA. Back then people were using some more permanent fillers like Artecol (Artefill) and... more
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
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