How do I get rid of granulomas from Volbella filler?

Question

I had tear trough and lip filler with volbella in July. In October I developed multiple hard lumps/masses at all injection sites in October. No redness. Just hardened filler. They have tried dissolving with hyaluronidase three times with no success. My sinuses have since been a non stop issue. The tear trough hardened masses feel like they are growing and there is pressure in the eye area, inner canthus area mostly. Suggestions? I need help.

Michael A. Persky, MD · Answer

Hi C,Sorry to hear about your complication with Volbella. I would recommend treatment with hyaluronidase along with Kenalog/ 5FU injections every three weeks.  I would also recommend oral Biaxin 500mg twice a day for six weeks.  There have been studies out of Israel on patients who received Volbella under their eyes who developed complications similar to yours.  Good luck and be well.Dr. P

Jason Emer, MD · Answer

Fillers like Belotero, Volbella, and Restylane Silk are good for improving under the eyes, but keep in mind that a combination approach will give the most improvement. My patients try to get non-surgical treatments to avoid surgery, so we use fillers, lasers, microneedling/PRP and stem cells. I suggest consulting with an expert to develop a treatment plan best suited for you. Best, Dr. Emer​​​​

Emil A. Tanghetti, MD · Answer

Nodules or inflammatory reactions after injection with the Juvederm product Volbella have been reported. I have seen a handful of cases of these reactions in individuals treated with Volbella in the lip area. These reactions have been reported weeks to months after injection and sometimes have been associated with recent dental work. Some people have felt that they are related to the development of a biofilm in the area of injection. They generally are best treated with a course of antibiotics. They generally take 6-8 weeks to resolve. Dissolving this type of hyaluronic acid can be challenging. I would suggest following up with a provider that you trust to discuss your options. If your treating physician has not done so already, I would suggest reporting this reaction to Allergan, the company that makes Volbella.

Charles R. Nathan, MD, FACS · Answer

If all the spots are hard, one may be concerned about a biofilm or low grade infection issue.  If the material has become infected by bacterial or fungal elements, hard areas may form.  Seek out opinions from experts experienced in this issue

Davin Lim, MBBS, FACD - Account Suspended · Answer

This is difficult to manage if it is true granulomas and not pseudo granulomas. Dilute steroids, or 5 FU can be used, there are some studies on the use of saline flushes, and other studies on diode wire guided lasers. An in person examination by your dermatologist or plastics of your choice will be needed. In some situations a neat excision is the definitive choice- depending on the anatomical site, and closure defect. All the best, Dr Davin S. Lim. Brisbane. Australia.

How do I get rid of granulomas from Volbella filler?

Answers (5)

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