Lump on Eye Bone 17 Months After Restylane Injection

You mention that the lump developed after the Restylane was injected.  Your photographs show a significant bump. I would doubt that this was a movement of the Restylane, and it could certainly have been  a hematoma which then over months, solidified rather than liquified. Some organized hematomas can even calcify and become quite hard! Surgical excision may be needed.  As the lump occurred quickly after the injection, it rules out an immune reaction termed a granuloma from the Restylane.  It also then would not be a traumatic epidermal inclusion cyst.  If the mass on examination is softer rather than hard, and a scan with contrast does not show any intracerebral connection and does not reveal any vascular connection, then possibly a trial of a hyaluronidase or corticosteroid injection may help. There are risks with injections around the eyes so be cautious.

Hi @SOBND! I recommend a trial of Hyaluronidase. Always treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

Hi SOBND,

Sorry that you have had this complication from Restylane in your lower eyelid area.  I have seen this one time, though it appeared 7 months after the injection of Restylane in the same area.  There was no hematoma or lump/bump until 7 months after treatment.  Make sure to have a small amount of hyaluronidase injected as a skin test in your arm prior to having it injected under your eye.  The  patient that I treated had a severe allergic reaction that took about 12 hours to resolve.   I hope that you lump resolves soon.  Good luck and be well.

Dr. P

Common things happen commonly.  The first three things this is likely to be is Restylane even though it has been 17 months.  You need to see an injector who is comfortable working with hyaluronidase.  This is the enzyme that dissolves the Restylane.  Oculoplastic surgeons probably have the most experience with this product.  If enough enzyme does not make this dissolve, then and only, other things can be considered.

The answer depends on what it is.  If it is scar tissue, there are nonsurgical and surgical options. If it is residual filler, it can be dissolved.  Recommend consult with an oculoplastic surgeon.

Dr Taban

Doubt it is hematoma, but did you have a large black and blue area after injection?   You can try massage and warm compress for awhile.   Restylane around the eye are orbital areas can stay for a year or two and if it is persistent from the injection, see someone who understands the anatomy well and can treat the problem.  Thanks   Cynthia Boxrud MD 

It is probably residual Restylane collection. Restylane and Juvederm in this area can stay for years. I've seen it last for 2 - 3 years easily. An injection of Vitrase can get rid of it in less than 24 hours. Hopefully the original doctor is able to do that, otherwise, find yourself somebody who can. 

The lump under the eye could be a persistent collection of restylane (likely), a scar (less likely, but occasionally when hematomas or blood collections under the skin resolve they can leave scars), or a granuloma (extremely rare and unlikely). 

Consider a trial of hyaluronidase injections to the lump by a practitioner experienced in working in the undereye area.

Although it is not comon for restylane to "hang around" for 17 months, it certainly could be restylane. It shoudl be evaluated. If it is, it may be able to be dissolved.

Sometimes hyaluronic acid fillers migrate from their original injection site, especially around the eye area, most likely having to do with the circular muscle that surrounds the orbit.

Hematomas resolve within two weeks or so.

This could be the filler still present but having shifted from original location.  Hyaluronidase would help dissolve it if it is.  However, first it needs to be established what the nature of the nodule is.  I would recommend an evaluation by a dermatologist or plastic surgeon with experience in hyaluronic fillers.