I Have Facial Asymmetry from Restylane Injection in Scar - when Will It Go Away?

I had a syringe of Restylane injected by my Dr. into a dent in my cheek from a cyst. I realize now that it was not a good candatite for Restalyne as the scar was deep and narrow - not shallow and smooth. It made the dent open up and spread out. I have a sort of swelled area or egg shape under the injected site - it's not actual swelling as the injection was 1 month ago - more like a ball of Restylane that is under the skin. This has caused some major facial asymmetry when will it go away?

Doctor Answers 13

Restylane for Deep Cyst Scar?

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Hi Lena.  If the scar is deep and narrow, it may be better suited to surgical revision like punch excision.

We do not use Restylane often for acne and other types of facial scars because usually surgical or laser options work better.  Because we do not have a picture, it's difficult to say exactly what's going on, but if the problem is the Restylane, it is easily reversed with Hyaluronidase (Vitrase).  Ask your injector about the product and have t reversed if the Restylane is the issue.

Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Facial asymmetry from Restylane may go away or can take years

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Facial asymmetry from Restylane may go away or can take years, depending on the area. Restyalne under the eyes can last a year or more. You really need to check with the doctor, potentially massage it or dissolve it with hyaluronidase. You can also add more Restylane around it to make it look better.

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

Dimple from restylene

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This should resolveĀ  ver several months.to get it to gone down quicker one can inject Hyaluronidase to get it to soften.Releasing the base of the scar with a sterile needle and then massaging it may also help.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 69 reviews

Restylane for scar

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Sometimes the scar is tethered down and the filler may tend to squeeze into the surrounding skin creating a donut effect. If this fullness makes the central depression more deep by contrast with the elevation in the surrounding skin, then it can be dissolved with hyaluronidase and after the area "quiets down" you can try again with subcision underneath the epidermis to lift it up and away from the dermis to which it is tethered. Then just a small amount of restylane may help. Unfortunately, even with the best dexterity and experience some scars are so dense or fibrotic that this would not be the best treatment for them and possibly punch graft and resurfacing might be better.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Filler into the area of a facial scar

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Hi Lena,

  This phenomenon can occasionally be referred to as the "donut effect." The hyaluronic acid filler (for example, Restylane) can actually end up depositing around the area of the indented scar. When it subsequently absorbs water from your body (which is one of the ways that hyaluronic acid fillers work) it can elevate the area around the indentation even more, making it appear more prominant than before the injection(s). 

   If your prior cyst (assuming it was at one time an inflammed acne nodule) was treated in the past with a steroid injection directly into it to decrease the inflammation, there is another option to help hasten the resolution of the indented scar itself (a series of saline injections into the site to break up the triamcinolone deposits that could be causing the atrophy, or indentation, of that skin).

  However, if your prior cyst was surgically removed and the scar to which you are referring is what resulted from that procedure, other treatment options exist, like fractionated carbon dioxide laser, subscission ("untethering" the scar from the underlying tissue - for lack of a better analogy), and possibly even very small amounts of medical-grade silicone injections, which tend to remain localized to where they are injected within certain types of acne scars than hyaluronic acid fillers do.

   To answer your question as to how long it will take for the Restylane to naturally break down, it depends upon several factors including where in the face the scar/hyaluronic acid filler is located. Restylane, Juvederm, and other hyaluronic acid fillers that are injected into areas of the face that tend to move a lot with facial expressions, eating, talking, etc. (for example, areas around the mouth) will not have as long lasting effects as those injected into relatively static areas of your face (for example, the full part of your cheeks and your temples). That said, it is relatively easy to break down the Restylane or Juvederm with subsequent injections of a substance called hyaluronidase, which can work as quickly as a day or two. The KEY is to go to a physician who is comfortable and experienced with using (and properly deciding upon the dose) of hyaluronidase.

  So, do not fear. . . you have several, good options for fixing the current problem you are having with that scar. Hope this helps! MK

Monika Kiripolsky, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Bump from Restylane Injection

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Any HA product can be "melted" away with a special injection.  I perform this injection several times per week on patients that have had injections at medspas or other places with inexperienced injectors.  Your doctor may be able to perform the melting injection or find you someone in your area that does.  The melting only works for HA products such as Juvederm and Restylane.


Good Luck.

Asymmetry from Restylane injections into a scar

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Restylane lasts about 6-9 months, in some cases a little longer.  Hyaluronidase can be used to dissolve the Restylane beneath the scar to restore the symmetry.

There are other ways to decrease the appearance of a scar, such as fractional resurfacing.  Fillers can be used in conjunction with that to elevate the scar as well.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Restylane in scar

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If you do not like the result that you got from restylane injection into the area, you can always have it dissolved.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Restylane resolves spontaneously

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Typically, Restylane results, bumps, asymmetries, etc resolve spontaneously. Restylane is not permanent. Generally, Restylane yields excellent cosmetic results without the above issues.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Restylane bumps usually resolve within 3 months

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Restylane bumps usually resolve within 3 months. This can be speeded up with gentle massage or with injections of hyaluronidase.

Edward Lack, MD
Chicago Dermatologist

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.