Can these filler bumps on temple be massaged flat, or is hyaluronidase needed? (photo)

Hello.  Hyaluronidase does not cause necrosis.  It is a very simple enzyme that breaks down Hyaluronic acid based products like Restylane, Juvederm, Perlane, Belotero and Voluma.  We have provided this procedure many times for patients that have been unhappy with injections at their other practices and have never had any side effects.  The decision to have or not have Hyaluronidase is a very personal one based on how much you dislike the current injections.  To see an example of before and after photos for a Juvederm reversal for eye bags for one of our Los Angeles patients, click the link below.

Longterm filler problems include migration, edema, and nodularity. Filler migration and permanence is a very common problem because there are many different types of HA fillers on the market and each is specified for a specific part of the face. Use of highly cohesive fillers on thin skin may cause swelling and nodularity. If patients have filler migration or nodules, we recommend a combination approach of filler reversal with enzymes Hylenex and Hyaluronidase in different strengths to dissolve the filler. We may also need to add Kenalog to the mix in order to reduce fibrous tissue. If the filler does not dissolve, it either means the filler is not HA material or we need more enzyme. The HA reversal can be combined with other lasers and skin treatments at the same time, and it usually (usually) does not affect adjacent tissue.

Best,
Dr. Karamanoukian
Realself100 Surgeon

This is likely swelling and clumping of the filler and can be reversed easily with hyaluronidase or evened out with saline injections.  I suggest seeing a filler expert for treatment and it is often better to have deep temporal injections in this area to avoid this complication. Microcannulas in this area are a good option though since they limit bruising and swelling most of the time.  Best, Dr. Emer.

There are countless horror stories about everything online....Remember that products don't have minds, and it's about the injector! In the right hands hyaluronidase is a wonderful procedure that dissolves filler and helps people return to normalcy. While the choice is a personal one, I have never had an issue using it, and I spend a great deal of time correcting the work of others and helping people look a lot better. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."