Hard Bumps After Sculptra on Forehead

Question

I had the injection done on my temples and forehead about 11 days ago. After the swelling and bruising went away, I was left with two very hard and large bumps. I have been massaging to try to break them up but they have not gone away and one of them has gotten bigger. They are very noticeable and painful. I have read that these can be permanent and get even worse. Is this true? Is there anything I can do?

Matthew Richardson, MD · Answer

Nodule formation is possible with Sculptra, and I tend to use this product primarily in the cheeks and temples. I do not use Sculptra in the forehead for this reason. I like to place Sculptra in the deep tissues, and the forehead has very little subcutaneous tissue to disguise any irregularities.
For any nodule formation, massage is generally the best place to start. Steroid injections, needle aspiration or manipulation, and surgical excision are other options. Be sure to discuss any post-injection concerns with your injector, and I always recommend seeing an expert physician injector.
All the best,

Sam Naficy, MD, FACS · Answer

I recommend massaging the area 5x/day for 5 mins each time over the next 5 days. If the bumps persist, I advise you see a board certified dermatologist or plastic surgeon for possible intralesional steroid injection.

William Ting, MD · Answer

Firm scar massage is key, 10x every 4-6 hours. If the bumps remain persistent, seek a board-certified dermatologist to consider intralesional steroid and or 5-FU injection to break down the scar tissue. With appropriate dilution and injection technique by a board-certified dermatologist or plastic surgeon, Sculptra nodule should be quite rare.

Cameron Rokhsar, MD, FAAD · Answer

I recommend massaging the area as frequently as you can to break up the nodules. This is common and can disappear with time and manipulation. Don't worry if there are still some areas of nodularity that you are unhappy with. Some physicians can effectively remove them with a small steroid injection or 5FU. 

	Best of luck!

Chris Thiagarajah, MD · Answer

Sculptra nodules can be broken up with kenalog or 5-fu. Also massage can be key. Plus a little time is needed.

Nathan Mayl, MD (retired) · Answer

We begin massage immediately after Sculptra using the 5 x 5 x 5 instructions:

Five times daily
Five minutes
Five days

Massge needs to be firm so that any uneven areas are made smoother.  Even now, it can be started.
You also can see your doctor and if he believes there has been too much put in an area rather than reaction to the injection, he can try to spread it about by using a needle to break up the area.

Hard Bumps After Sculptra on Forehead

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