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What to Do when Restylane Won't Dissolve?

asked 3 years ago by Michelle444 in new york, NY
Latest answer by B. Pat Pazmino, MD
Question viewed 3,492 times
Tags: hyaluronic acid

I had Restylane injected under my eye area a year and a half ago. It has not dissolved on its own.

It seems to have caused some extreme heaviness in my cheek area that has cause my mouth to look like its pointing downward. The left cheek is much bigger and both sides look different. Also, when I smile the cheek pushes up so high into the eye area and causes so many lines under my eyes it looks terrible.

Can I use something to remove it?

14 answers to What to Do when Restylane Won't Dissolve?

Massage-Dont have any injections around the eye-extreme case surgical removal

I dont do filler injections around the eye-there has been a reported case of blindness following filler injection close to the eye I dont use hyaluronidase injections-some experienced doctors do-but I would not around the eye. I agree with Dr. Wallach- after a year most of what you feel as a lump is scar tissue-Restylane dissolves fairly rapidly-studies show most gone by a year and a half. I would just continue to firmly massage the lumpy area-you can mold scar tissue over time with massage... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

You need a careful examination

Michelle, The Restylane should be completely gone by now. You really need to either go back to your original injector or seek out someone who specializes in injections and periorbital surgery. It sounds like you may need some type of intervention, but you need a complete evaluation prior to rushing into anything. David Shafer, MD

David Shafer, MD
New York Plastic Surgeon

Go back to your physician and study your before and after photographs; Restylane is not the cause!

Restylane is comprised of hyaluronic acid which typically lasts between six to nine months. After a year and a half, I seriously doubt that the changes you described are totally attributed to Restylane. There could be other things going on. I suggest that you go back to the physician who performed the injections and confirm that this was the product that was utilized. I hope that pre-injection photographs were taken in order that you can diligently study and compare them to recent... more

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Restylane is not the cause

It sounds like you have a somewhat complicated problem that requires detailed examination. I doubt that Restylane is the culprit. Restylane would be long gone at a year and a half.

George J. Beraka, MD
Manhattan Plastic Surgeon

Something does not add up

You are attributing a large number of findings related to aging to an injection of Restylane more than a year ago. Even if the Restylane was injected around the eyes, in an off-label use manner, the Restylane cannot be the reason for the corners of your mouth turning down. The only filler that I have seen to cause the symptoms you describe is silicone microdroplets. I have had many patients who present for facelifts with silicone in their cheeks and describe the same symptoms. Are you sure... more

Robert M. Freund, MD
New York Plastic Surgeon

It may be that you didn't get Restylane, but another, more dangerous filler

Restylane is a great product in that it is very easily dissolved if it is not doing what you want it to do, but my concern is that you didn't receive the real thing. There are many other fillers out there, some of which are very scary as they don't go away after 6 to 12 months and can even be permanent and cause permanent scarring. The most concerning of these fillers is silicone, but there are others like Radiesse, Sculptra and Artefill that may be what was used here. I agree with the... more

Joel Schlessinger, MD
Omaha Dermatologist

www.LovelySkin.com

Hyaluronidase

Hyaluronidase will dissolve any hyaluronic acid filler. Juvederm works extremely well in my hands, albeit as an off-label use, to treat the hollowing of the lower eyelids. Very conservative volumes are used.

Min S. Ahn, MD
Westborough Facial Plastic Surgeon

Persistent Restylane problems

Restylane is a powerful and effective dermal filler that usually lasts approximately 6 months. It sounds on your case your Restylane has lasted much longer than that. This may be due to some leftover Restylane in your tissue or it may be due to swelling or a small amount of scar tissue in your skin around the original Restylane injection. At this time, scheduled a consult with a board-certified plastic surgeon who will be able to determine the cause for this firm tissue. If you have... more

B. Pat Pazmino, MD
Miami Plastic Surgeon

See your doctor for Restylane bumps after 18 months

While it's possible that Restylane may be still present in your cheeks 18 months after injection, it's unlikely. It sounds like there is something else going on. Before suggesting what it might be, it's best to visit your practitioner for an evaluation. If it is still Restylane, Hyaluronidase can be used to break down and dissolve the Restylane. First step is to back to your physician or be seen by another.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon

Cheek firmness after restylane injection

Hyaluronidase is a naturally occuring enzyme that is produced by bacteria to help them dissolve the hyaluronic that exists in normal tissues. This can be used to help dissipate the restlyane if that is the cause of your problem. Other possiblities include a hematoma with fibrosis.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

When Restylane won't dissolve

I would go back to your Restylane injector and have him / her dissolve your Restylane with Hyaluronidase; An enzyme which literally breaks up hyaluronic acid, the active ingredient in Restylane, Perlane and Juvederm. Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon

Heaviness and Restylane

It does sound that the heaviness more than one year after the Restylane could be caused by multiple reasons, which may not be Restylane. You should see your physician for evaluation as most of the REstylane probably has dissolved by now. If it is the Restylane it would be an exceptionally rare situation that deserves an in-office examination.

Ronald Shelton, MD
Manhattan Dermatologist

www.thenyac.com

Changes may not be due to Restylane

Restylane rarely lasts more than 12 months. If your Restylane was injected only in the lower eyelid area I would not expect it to spread out and cause other problems. If you have some lumpiness in the lower lid area then this could be attributed to your injections. I would agree that an evaluation is required.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Off-label use

Fillers in and around the eye are used in an off-label fashion. Because restylane is a hyaluronic acid product, some physicians are using hyaluronidase to dissolve unwanted restylane. This is also off-label use of this product. It may not help a year and half later, because you may have a foreuign body tissue reacton to the restylane which should have broken down months earlier, or you have residual edema from the product.