Filler still present and bumpy after 3-5 years, should I be concerned and will this eventually dissolve on its own?

Question

I had CaHa filler (Crystalys) of 1ml and twice hyaluronic acid (regenovue) of 1.1ml injected for treatment of scarring. This worked fantastic but some of the fillers are still present even though the treatments were done 5, 4, and 3 years ago starting with CaHa filler. My worry is that I can still feel lumps of the fillers, especially CaHa filler in my cheeks and smaller lumps from ha injections. Is this normal or should I worry about possible infections on these sites? Will they ever dissolve?

Eric M. Joseph, MD · Answer

If there is no redness and pain, you probably don't have an infection. Palpable bumps or nodules can occur after injectable filler treatments, and these may be permanent. If they are only palpable and not visible, I wouldn't worry about them. Thank you for your question. Sincerely, Dr. Joseph

Anna Chacon, MD, FAAD · Answer

It's understandable to be concerned about filler persistence and lumps several years after treatment. Here’s a breakdown of the key points related to your situation:

Calcium Hydroxylapatite (CaHa) Filler (Crystalys)
1. **Longevity**: CaHa fillers are known for their longevity, typically lasting up to 18 months. However, in some cases, they can persist longer.
2. **Palpable Nodules**: It’s not uncommon to feel nodules or lumps after CaHa injections, especially if they were placed deeply. These can sometimes persist for years.
3. **Dissolution**: While CaHa fillers are designed to be biocompatible and eventually metabolized by the body, this process can be slow. Some residual material might remain for an extended period.

Hyaluronic Acid Fillers (Regenovue)
1. **Longevity**: Hyaluronic acid (HA) fillers usually last between 6 to 18 months, depending on the product and area of injection.
2. **Palpable Lumps**: Small lumps or irregularities can sometimes be felt after HA injections. These usually dissolve over time as the body breaks down the HA.

Concerns and Actions
1. **Infection Risk**: The risk of infection from filler injections typically decreases significantly after the initial healing period. However, if you notice signs of infection (redness, warmth, pain, swelling, or discharge), you should seek medical attention promptly.
2. **Persistence of Lumps**: While it’s not unusual for some filler material to persist, especially with CaHa, persistent lumps after several years should be evaluated by a healthcare professional. There could be other underlying issues that need addressing.
3. **Resolution**: Both types of fillers should eventually dissolve, but if the lumps are causing discomfort or aesthetic concerns, treatments such as hyaluronidase injections (for HA fillers) or steroid injections might be considered. In some cases, surgical removal might be necessary for CaHa fillers.

Recommendations
1. **Consultation**: Schedule an appointment with a dermatologist or a plastic surgeon who specializes in filler treatments. They can assess the lumps and determine the best course of action.
2. **Imaging**: In some cases, imaging studies (like ultrasound) might be used to assess the extent and nature of the filler material.
3. **Management Options**: Depending on the evaluation, options might include observation, massage, hyaluronidase injections, steroid injections, or surgical removal.

While it’s not uncommon for some filler material to persist and be palpable for years, it’s important to have it evaluated to rule out any complications and discuss potential treatment options. Persistent lumps are not typically a sign of infection after such a long period, but professional assessment is essential to ensure there are no underlying issues.

Camille Cash, MD · Answer

If the lumps that you feel are not painful, unsightly, or causing issues it is fine to leave them alone.  If you are unsure you can visit with your injector for an evaluation.  These treatments typically are not present this long after injection, but it can occur.

Filler still present and bumpy after 3-5 years, should I be concerned and will this eventually dissolve on its own?

Answers (3)

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