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Why Does Restylane Cause Little Bumps Under the Skin?

A lot of people say that after their restylane injections, they can feel bumps under their skin for a long time.  Why does this happen to some people and not others?  What causes the bumps, and more importantly, how can I make sure that I don't get them?

Sort 14 expert answers by:
+7

Restylane does not cause bumps under the skin...

Restylane does not cause bumps under the skin unless: It is injected too superficially It is injected unevenly Skin reactions or prolonged inflammation related to the injection of Restylane are extremely rare (I, personally, have never seen it). Areas where the skin is thicker, such as the nasolabial folds, are much less likely to end up with bumps, compared with areas where the skin is very thin, such as the tear troughs below the medial lower eyelids. I recommend... more
John M. Roesler, MD
Los Angeles Facial Plastic Surgeon
+6

It even has a NAME

Bumps close to the skin after a Restylane injection is caused by the injector pushing on the plunger as the needle is being withdrawn.  It causes bumps that will sometimes have a bluish hue to them.  This is called the Tindall effect.  It is seen whenever the product gets too close to the skin or the skin is especially thin (i.e. around the eyes).  Other lumps that are deep but not blueish should be gently massaged smooth at the time of... more
John Bitner, MD
Salt Lake City Facial Plastic Surgeon
+3

Restylane injection technique is very important to avoid bumps

Great question. Technique is probably the answer. Fillers can be bumpy but massage at the time of placement is vital to smooth it out. Also, a smooth, even delivery of filler by the doctor during the placement can help avoid that. I find that I prefer a patient to have a numbing block prior to treatment so that it is painless for the patient. If that is the case, I can massage the area without any discomfort and can do get a better result. It also takes a few days for the filler... more
Robert F. Gray, MD
Bay Area Facial Plastic Surgeon
+3

Help to minimize Restylane bumps

Thank you for your question. Injection technique is primarily responsible for bumps after treatment. While this is injector-dependent, you can also do things to reduce bumps. The main post-injection practices that you can do are gentle and repeated massage, and ice application to minimize swelling. You only have a 1-2 day window of massaging to move the Restylane around and minimize the bumps. If you notice a "blue bump" in the skin that does not improve after massaging, that may... more
Don Mehrabi, MD
Beverly Hills Dermatologist
+2

Restylane is best injected into the dermis

If Restylane is injected too superficially, one can feel pumps under the skin. Also, if too much product is injected in one location, the bumps can result. It is all technique and injector dependent. That is why this is more of an art than a science and it is really important to research and find an experienced injector. Also, if injected too superficially, you can have a "blue" hue to the skin. If your doctor leaves you with bumps that you can feel and see,... more
Michele S. Green, MD
New York Dermatologist
+2

Good filler placement should not leave obvious bumps

Experienced injectors should not leave visible bumps when injecting at all, and should leave few if any bumps that you can feel. The trick to quality placement of Restylane or any filler is for it to FEEL as natural as possible and also LOOK as natural as possible. Small translucent or blueish bumps, if noticed right away, can be easily repaired before the filler starts to cause collagen building and longer term settling into the skin. Do not be afraid to ask your doctor about any... more
Jessica J. Krant, MD, MPH
Manhattan Dermatologic Surgeon
+2

Restylane and bumps

Restylane if injected very superficially can cause bumps.  The best way to avoid this is by injecting deeper. In addition, if lumps are felt, they can be massaged to soften them.
Steven Wallach, MD
Manhattan Plastic Surgeon
+2

How to get smooth results from Restylane

Properly done, Restylane and Juvederm should not leave lumps. There are several techniques that are used for dermal fillers, and the original one is called "serial puncture" in which a series of injections are done along the wrinkle. This is more likely to leave bumps in my opinion, and I more commonly do "linear threading" in which the product is layered along the wrinkle being filled. There are several variations on each of these, but lumpiness should be avoidable.... more
Richard Baxter, MD
Seattle Plastic Surgeon
+2

Restylane should not cause bumps with good technique.

Hi! It's all about the doctor doing the injections.  With good technique, you should not get bumps after Restylane or Juvederm injections.  Go to an experienced plastic surgeon.
George J. Beraka, MD
Manhattan Plastic Surgeon
+2

Bumps from Restylane

If you feel bumpiness after Restylane, it is likely that you have a small concentration of product around an injection site. When this occurs, it is possible to massage the area to smooth out the bumps, although this procedure is something we like to avoid as it may lead to shorter duration for the product if too much massage is necessary. To avoid bumps, make sure to choose a practitioner carefully. If the injections are done with the proper care, you should not have much bumpiness at... more
Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
+2

Palpable bumps on the lips after Restylane injection

It is normal to feel a filler which is injected beneath the skin to plump up a wrinkle or depression-however a smooth fullness is what we try to achieve. When patients complain of lumps they are usually referring to an uneven injection-that is the rate of the filler injection is uneven so some areas have little 'balls" of filler while the adjacent area has less or none because the pressure of injection was less asthe needle was withdrawn form the area. Good manual dexterity and lots of... more
Brooke R. Seckel, MD
Boston Plastic Surgeon
+1

Bumps under the skin following Fillers

A patient question regarding bumps under the skin following a Restylane injection by their doctor can be explained by a couple of causes. The first one is that early lumps or the ability to feel the hyaluronic acid filler( Restylane or Juvederm) for the first several weeks is normal. Whenever we place a filler under the skin, the body's first response is to say "hey what is this?". During this initial stage the patient often experiences some swelling and will... more
Brian Maloney, MD
Atlanta Facial Plastic Surgeon
+1

Restylane should not cause bumps under the skin

The skill and experience of the injector is key to a good outcome with Restylane and any other filler.  Technique is so important to reducing the risks of bumps.  If a bump happens, it can either be massaged away or dissolved with hyaluronidase.
Margaret Weiss, MD
Baltimore Dermatologist
+1

Why Restylane causes bumps under the skin

Restylane is a filler and is designed to push up a wrinkle or a depression. Therefore, it is perfectly ok for you to feel it. You can sometimes feel it from the outside skin surface or from inside your mouth. As long as it looks good, there is no problem. However, if the lump is very noticeable, that may be from an uneven or too superficial injection. That can usually be corrected by pushing directly down on the spot to mold or flatten the product. I usually use a q-tip but you have to be... more
Joseph Rabson, MD
Philadelphia Plastic Surgeon
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