Lumps after Restylane fillers. What should I do? (Photo)

Question

I have one lump under each eye after getting Restylane fillers six weeks ago. They have a greenish hue to them, and they’re firm but not hard. They’re more noticeable in outdoor or overhead lighting. I’ve had Restylane fillers in the past and didn’t have this problem. My wedding is in three weeks, what should I do? Massage them, get them dissolved and risk bruises, or let them go away on their own? Help!

Nima Shemirani, MD · Answer

Hi @kate03rich. Chances are the filler was not placed in the proper tissue plane. Most facial filler products that are injected into this area should ideally be placed in the tissue plane directly on top of the bone, or at least underneath the eyelid muscle layer. If a facial filler product is placed too superficial in the skin, or on top of the muscle layer, the product may settle in with an abnormal appearance and can look to be lumpy, swollen, or irregular. Hyaluronic acid facial filler products that were previously injected into an improper tissue plane can be dissolved by hyaluronidase injections.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having from your Restylane treatment.  Visit with your injector for an evaluation.  It is likely since the treatment was 6 weeks ago that if you want them gone you will need to dissolve them with hyaluronidase.  To keep bruising to a minimum avoid aspirin, NSAIDs, Vitamin E, fish oil, and other medications that can cause blood thinning prior to treatment.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  I would recommend seeing a Board Certified Plastic Surgeon or Dermatologist in person to talk about dissolving the product.  Massaging will help break the product down a little faster as well.  Congratulations on the wedding and best of luck.

Bradley Bengtson, MD, FACS · Answer

Filler to the tear troughs are among the most
challenging injection as scrupulous technique and follow up are routinely
required.  For this reason, I suggest evaluation and treatment by a
provider well versed in injectables and with extensive experience in facial
anatomy and treatments.  Follow up 2-4 weeks after tear trough injection
is my standard protocol.  I suggest that you follow up with your provider
to discuss the best next step to reach our optimal outcome.  Best of luck!

Jonathan Kulbersh, MD · Answer

Thanks for your question and photos. At this point, I think your best bet may be to dissolve the filler as soon as possible to give the area time to heal before the wedding. However, you should schedule an in-person consultation with a board-certified plastic surgeon who is also an expert injector for a full assessment and treatment recommendation. Best wishes for a wonderful wedding day!

Lumps after Restylane fillers. What should I do? (Photo)

Answers (5)