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

Question

Got 2ml of thin HA (particles .1-.15mm, 200k/ml) 8 days ago. I wanted it deep, but doctor insisted on under skin, scared of hitting an artery and blinding me. She put in 1.5 (via cannula/fern pattern) and it looked nice and flat, but still a little hollow. Adding 0.5 made it into this monstrosity. I really don’t want to do hyaluronidase; there are countless terrible side-effect (including necrosis) stories on realself et al, but nor do I want to look like a Star Trek character for a year.

Harold J. Kaplan, MD · Answer

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.

Raffy Karamanoukian, MD, FACS · Answer

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

Jason Emer, MD · Answer

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.

F. Victor Rueckl, MD (in memoriam) · Answer

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."

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

Answers (4)

Answer: Do I need hyaluronidase

Answer: Do I need hyaluronidase

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Everything you need to know about Hyaluronidase

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

Answers (4)

Answer: Do I need hyaluronidase

Answer: Do I need hyaluronidase

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Recommended reading

Everything you need to know about Hyaluronidase

Our mission is to create a world where every investment in modern beauty is Worth It.