Complication from filler in nose, Cat scan shows nothing on nose but swelling in cheek, advice? (Photo)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. I'm sorry to hear this! Given your experience with persistent hardness, pain, and swelling following multiple dissolving treatments for Restylane filler in the nose, it's crucial to address this issue comprehensively. The hard nodules you describe, combined with ongoing symptoms despite extensive treatment with antibiotics, oral steroids, and cortisone injections, suggest that there may be residual inflammation or fibrosis in the affected area. The fact that the CT scan indicates swelling extending into the cheek further complicates the situation. In this case, a multidisciplinary approach might be necessary. Consulting with a specialist in dermatology and/or plastic surgery who has experience with filler complications is essential. They may recommend advanced treatments such as ultrasound-guided techniques to assess and manage deeper tissue issues or further interventions like hyaluronidase injections to address residual filler or scar tissue. Additionally, exploring non-invasive treatments such as radiofrequency or laser therapy could help reduce fibrosis and improve skin texture. Persistent issues like yours may also benefit from a review of your treatment history and potentially seeking a second opinion to ensure a comprehensive management plan. I hope this helps and best of luck!

Dermal fillers are easier to identify with ultrasound and MRI than on CT scan. Dermal filler is pretty subtle on CT scan and the tip of the nose is such a small and confined space, I'm not surprised it was not identified with CT scan. Ultrasound, in experienced hands, has the benefit of allowing real time guidance of the needle to do targeted dissolve. All my best, Dr. Shaden, Woodland Hills, CA