Lump remaining after hylenex used x4 (Photo)

Question

I had undereye filler (a dissolvable hylaloronic acid filler) approx 2 years ago and recently felt it was starting to look lumpy/bulky. I got it dissolved with hylenex, which was successful with the exception of one lump. I have since attempted to have it dissolved with hylenex again x3 without success. The injector explained it is just my anatomy, however I never had this prior to fillers. It is hard and not moveable when I press on it. It almost feels like it is attached to my obital bone.

Monika Kiripolsky, MD · Answer

Hi,
It’s tough to determine from your photos. It’s possible that it’s your middle infraorbital fat pad. Fat pads typically bulge out and become more prominent when you look up at the ceiling. A series of 3 sessions with hyaluronidase 3 years after hyaluronidase acid filler should definitely be sufficient to break down any residual HA filler that might’ve been remaining. Are you sure that there was not any Radiesse (calcium hydroxylapetite) mixed in with the hyaluronidase acid filler you had injected 2 years ago? If so, a little intralesional steroid injection might help.
Regardless, I hope this helps and encourage you to come in for evaluation of you are in the Beverly Hills area.
Dr. Kiripolsky

Harold J. Kaplan, MD · Answer

Hello AC.  Although it's difficult without an in person evaluation, it does appear you may have some product left over.  If you want to try again and are not satisfied with the answer you are getting from your own practitioner, perhaps it's time to get a second opinion.  In some cases, and it depends on the filler used and location placed, more than 1, 2 or even 3 visits may be required to get rid of the filler (see link).  Best of luck.

Nelson Lee Novick, MD · Answer

From the photos provided, this might possibly be a persistent granduloma or nodule that has simply not responded to conventional hyaluronidase treatments (assuming appropriately high enough concentrations and amounts were used). Or this may be lymphatic obstruction (lymphedema) or a nodule complicated by this, which can be quite difficult to treat.  I have had success with treating such conditions using an algorithmic approach using a variety of intralesioal anti-inflammatory agents. You would  be wise to consult an experienced, board certified dermatologist physician injector. Hope this helps. Best of luck.

Lump remaining after hylenex used x4 (Photo)

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Lump remaining after hylenex used x4 (Photo)

Answers (3)

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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.