Lump under eye after fillers, granuloma?

Question

Hi, I had voluma in my cheeks, and now have a 1.5cm diameter lump under my eye (about 1/5cm below, on my cheek) its hard and feels tender. I had the injections 6 days ago and its not gone down. I'm really worried. It was by a trusted aesthetician i've been to before but never for fillers. I'm really worried it’s a granuloma and i'm scared. The clinic is now shut until mid-Sept. Should I be worried or is this normal? The others injection sites are fine, its just this one that is like this.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. While each patient heals from surgical and non-surgical procedures differently, the side effects you are experiencing from Voluma seem to be common and tend to subside shortly after the injections. Please discuss with your board certified facial plastic surgeon.
Best wishes,

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry to hear of your difficulties after filler placement.  It is difficult to offer advice without a full series of photogrographs but most fillers take up to 2 weeks to soften and the tissues to appear more natural.  In the meantime try reducing any remaining swelling by using cold compresses, elevating your head at night with a couple of extra pillows behind your back, and Arnica Montana and bromelain as supplements.  Hang in there!  If after 2-3 weeks you are still not seeing improvement, have your injector dissolve the filler with hyaluronidase.  Best wishes.

Aldo Guerra, MD · Answer

I'm sorry for your concern. You should not worry about granuloma as you cannot get one in just five days. You need to go see your injector today or tomorrow if your lump is really that big. Best wishes, Dr. ALDO

Kyle T. Yamamoto, MD · Answer

Without photos and a full examination, it is difficult to know exactly what is going on.  Six days after an injection, however, is still fairly early and the most likely possibilities have to do with swelling or bruising in the area from the injection.  Generally a granuloma would not form so soon after an injection.
If the area is tender, some ice can help with comfort.  Give the area more time to heal from the injection. I tell my patients to wait at least 2 weeks before evaluating the final result.
Should the bump persist after 2-4 weeks, you can have the area treated with an injection of hyaluronidase to dissolve the filler in the area.  Often, this will help resolve the bump.  Waiting until mid-Sept to go back to see your injector is a fine amount of time to wait.  If you need to see someone sooner, I recommend visiting a facial plastic surgeon or plastic surgeon who does his/her own injections.  In my opinion, they are the best individuals to perform injectables and address potential complications from them.
Best of luck!

Beata Danek, MD · Answer

Most likely it is not a granuloma - it should take more than 6 days to form. If your lump is getting worse I would be worry about infection and suggest to see your medical doctor if your injector is not available. If it is the same or improving - apply warm compresses and observe for 2-3 weeks. Cold compresses help within first few days, but not after 1 week. It can be small blood clot under your skin that will go away within few weeks. For excessive Voluma pocket under your skin your injector may recommend hialuronidase to dissolve it. I hope it will work well for you.

Renata Wix-Harris, MD · Answer

I suspect that this most likely represents a bruise and/or swelling from the injection. A granuloma doesn’t develop that fast. Bruising resolves on its own in 7-10 days and it can take 2-4 weeks for the Voluma to settle and the swelling to resolve. If you are still unhappy with the results after that time you can have it dissolved with hyaluronidase. They development of redness, warmth or significant pain can indicate an infection, in which case you will need to see your provider or if unavailable another physician ASAP. Good luck!

Mehdi Sina, MD · Answer

Hi,
Of all the possibilities, I think a small hematoma (collection of blood) is most likely. Hematoma's that are not actively getting bigger do not need emergency intervention and the body absorbs the blood in a few days. Another possibility is that the voluma was injected too close to the skin and you are feeling the filler in which case you may need it dissolved. I would wait a full 2 weeks and seek further treatment if it is not any better.
Best,
Mehdi Sina, MD

Lump under eye after fillers, granuloma?

Answers (7)

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