Surgical Removal of Evolence Lumps?

Is there any hope of removing lumps caused by Evolence? The two lumps are under my right eye for 18 months now. If it was removed surgically, does it leave a scar? Can a minimal incision be used to remove the material? How much does it cost to remove the lumps?

Doctor Answers 1

Evolence bumps or something else?

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Evolence has not been on the FDA approval list here for that length of time. Are you sure the product is Evolence? Evolence Star trained physicians would likely not inject this product near the eye as it is not meant for that area. Most fillers are used off label in extended areas to some degree, but most doctors are pretty conservative in that respect.

This brings up the discussion of making sure a physician has the relevant training for the injections you receive. The manufacturers go to great lengths to properly train physicians once the product is approved and available.

Evolence only received FDA approval in late 2008 at which time public distribution began. For you to have had this particular filler for 18 months at this date (8/09) would indicate you received it out of the US. Other than clinical trial doctors, I don't know who else who would have had legal or approved access in the US - and to my knowledge clinical trial physicians only treat in the area of the study - in this case the Nasolabial folds.

In my own practice I've found Evolence to be a very useful filler for buttressing the corners of the mouth as well as lifting Nasolabial folds and have no reports of problematic side effects.

As far as removal of any product in the skin, you should see a plastic surgeon who can make sure the incisions are the most minimal.

Still, I'm a little perplexed at your problem. At 18 months the body has typically broken down all the degradable fillers (Evolence is a degradable collagen of porcine origin). It could be the bumps are not actually filler. Without seeing you, it's impossible to really tell if this is filler or an anomaly caused by something else.

I wish I could give you a better answer, but only a doctor who sees you in person can make a judgment as to what the options are based on the true cause of the unexplained lumps.

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