Perlane: Q&A
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Can a Physician Safely Remove Hard Restylane Nodules - and How to Find That Specialized Doctor?
I had Perlane over three years ago, and it developed hard nodules around my mouth and in the naso folds. Three rounds of Vitrase have not removed the balls around my mouth. Is there a technique or physician who can help? One doctor said scar tissue had been formed, another said muscle. I tried more restylane in the upper face to balance it, but everything seems to swell in lower face after a few weeks (similar to Farah Fawcett - not as bad). What options are there?
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9 Doctor Answers |
Asked by
CharlotteNC
in Charlotte, NC
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Perlane and nodules
Dr. Shelton answers this as I would have. It's very unusual to have an allergic or immune reaction to the product but in this instance, it could be the case.
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Fort Lauderdale Perlane
Prolonged nodules always make me suspicious of mixing hyaluronic acids with permanent fillers such as silicone or Artefill. Surgical excision, or kenalog injection every six weeks, are your two best options.
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Perlane duration
It would be highly unusual for Perlane to last three years. It is more likely that you have had a foreign body reaction to the injection. If this is the case, discuss with plastic surgeon, but hyaluronidase will not work.
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Hard nodule after Perlane
Hard nodules after Perlane may indicate that this is a very rare granuloma, an immune reaction to the product that rarely ever happens, or it was not Perlane but a different product, or a biofilm has attached itself to the outside of the product and a collagen type of scar capsule has been created. Antibiotics and a biopsy may be worthwhile prior to an excision of the material. I would not suggest much more filler in the adjacent areas until more is known.
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What to do about hard filler nodules present after 3 years?
It is excedingly rare to get hard nodules from a hyaluronic acid filler, especially those lasting for three years. Hyaluronic acid fillers last approximately a year at most.
When there is a reaction to hyaluronic acid fillers, it is usually redness, swelling, bruising or pain.
However, sometimes hyaluronic acid fillers like Restylane or Perlane are used in combination with more permanent fillers like hydroxyethylmethacrylate (HEMA) and ethylmethacrylate (EMA)...
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Can a Physician Safely Remove Hard Restylane Nodules - and How to Find That Specialized Doctor?
Does seem odd if it was an HA injected. But anything is possible. Excision might be your only choice! From MIAMI Dr. darryl J. Blinski
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I do not believe this is Perlane
I would get your records and verify that the doctor reported this odd event to Medicis. Odds are, you were told it was Perlane, but it was a different product, and possible one not legal in the US. This happens more than you would think.
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Hyaluronic acid filler nodules
A good first step would be to get the records from your injections. It makes a difference what was injected as to what the treatment is.
Many times patients are told or recall that they have had one filler, only to find out they had something different.
If hyaluronidase has not helped, patients can consider focal steroid injections, or have the lumps excised.
More problematic fillers are the semipermanent fillers and silicone, the worst im my opinion.
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Scar tissue afer filler
If the hyaluronidase did not help then it may be scar tissue and you may want to consider having it excised if it is bothering you.
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