Can Restylane Become Encapsulated and Cause a Scar?

I received Restylane in my tear troughs in Jan. of 2010. The next day I noticed a small, catepillar-like lump underneath the eyelid. Nearly 15 months later, it's still there. I thought I would wait it out, since Restylane only lasts 6-9 months. Now, I'm wondering if the superficial placement of this bleb of filler caused a scar to form around the material, or if the bleb is still Restylane. I'm afraid to have hyaluronidase injected if it's really a scar. What are my options?

Doctor Answers 9

Lump after restylane for eyelid

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if the bump happened immediately after restylane was injected in the eyelid, then you shouldn't have an issue with a scar. Scars take much longer to occur. Ask your doctor if they think the hyaluronidase is worth a "shot" !  Pardon the pun. The hyaluronidase would not make the scar worse.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

It looks like you have what is called the tindal effect

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Any injection can cause a scar.  This looks like you need hyaluronidase.  It looks like you have what is called the tindal effect, as far as I can see.  It is not encapsulated, but rather it’s the product that refracts the light causing an appearance of a bluish color.  The first step is to inject hyaluronidase.  It’s very safe and there’s no downside when it’s done by someone who is experienced.  I wouldn’t think that this is encapsulated, which would be extremely unusual.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Restylane remnant

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Most physicians agree that hyaluronic acid lasts a long time in the periorbital areas and that small amounts placed deep to the skin are best.  Your photo appears to show Restylane which may have been placed too superficially.  I concur that Hyaluronidase should fix your problem.  Good luck! 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Restylane does not Encapsulate or Scar like Silicone Implants

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Hi mgardot82,

Minor lumps or irregularities after Restylane injection can occur. However, these are typically not encapsulated material. I agree with other cosmetic specialists that hyaluronidase is the best option to help improve any irregularities which are due to the material itself. Only after a comprehensive evaluation can one help determine appropriate options for you. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Hyaluronidase will make you happy

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I agree with those that recommend hyaluronidase. It will probably work and should not harm anything. You can then decide whether to try again, 

Jo Herzog, MD
Birmingham Dermatologist
4.8 out of 5 stars 20 reviews

Definitely get enzyme!

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Restylane does not stimulate scar tissue. The photo very much suggest high dermal rifting with filler. The easiest way to resolve this is by injection with hyaluronidase. The enzyme does a great job resolving these types of issues and there is no reason why you have had to live with a ridge like this.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Restylane and scarring

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No, that's unlikely IMHO.  The lower eyelid skin is very thin and it was the Restyalne itself that most likely made the lump in the first place.  It's lasting a long time but it's most likely going to flaten out eventually.  You could see a Dermatologist that's willing to place some hyaluronidase in the area and see if that breaks it up.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Restylane in the tear troughs

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Restylane in the tear trough or peri-orbital region has a much longer duration than when placed in the lower 1/3 of the face.  It can last from 1-2.5 years in this location.  In essence it is absolutely possible and most likely that the lump you are seeing is Restylane there.  It needs to be injected with Hyaluronidase which is an enzyme that will harmlessly dissolve the Restylane away in a matter of hours.  Once you are back to baseline, you can refill this area to smooth correction again.  Hope this was helpful.


Dr D

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Restylane lasts longer in tear troughs

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It is still possible that the lump you are referring to is still Restylane.  The only reports of possible encapsulation  of Restylane in the skin is from a paper describing a treatment with radiofrequency like Thermage over the injected areas of dermal fillers.  No other reports were found.

Hyaluronidase does not harm scar tissue anyways.  It only dissolves hyaluronic acid, natural or filler.  The natural hyaluronic acid does come back to normal after 2-3 weeks.

Emily Altman, MD
Short Hills Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.