How long will this delayed reaction to Volite last? (Photo)

Hi Barbara,
Late onset of nodules are most likely related to your body's immune system reacting against the cross linked hyaluoronic acid (HA). These reactions often follow an infection or immune response unrelated to the dermal filler. Prednisone injection or a one week course will normally help to settle things down. Episodes may reoccur and normally respond again to a repeat course of prednisone. This is unlikely infection; however, consideration has been given that these late nodules are related to biofilm introduced at the time of injection. The biofilm becomes active as the product breaks down. Based on the biofilm theory, many physicians will recommend antibiotics. Use of Hyaluronidase to dissolve the nodules can be challenging with Volite because the injected product is small in size and injection sites are numerous. The Vycross technology used in Volite, Volbella, Volift and Voluma can be more challenging to dissolve than other products because of the cross linking of the HA.
Doing nothing is an option, as most nodules will in time resolve spontaneously. Some physicians will consider biopsy and culture of one of the nodules in order to better understand what is going on. My experience with this is that the reports normally describe a granuloma and no cultured bacteria. In your case, where the problem is quite noticeable, I recommend treatment with prednisone. This reaction should be reported to Allergan and to Health Canada by your physician. Good luck and please do not worry - there will not be any permanent or long term problem associated with this reaction.
Regards, Dr Ray