Two and a half years after dermal fillers I have lumps on my face - how can I reduce these? (Photos)

Question

Hi there, I had 1ml Stylage put in my face approximately 2 and a half years ago. Over the last 6 months I have noticed that there are two lumps on both sides of my mouth. I tried to have this dissolved with two sessions of hylase but it was to no avail. I’m not sure what to do to help reduce these now. Surgery would leave permanent scars and I’d really like some help.

Anil R. Shah, MD · Answer

Marionette lines + prejowls + skin laxity: These are structural changes in the lower face:

Loss of midface and jawline support

Descent of fat pads

Skin redundancy

So even if the filler lumps were gone, the underlying age-related structural changes would still contribute to the appearance.

Anna Chacon, MD, FAAD · Answer

It’s understandable to feel frustrated when lumps remain this long after filler placement, especially after trying hyaluronidase without success. Since Stylage is a hyaluronic acid-based filler, it normally should dissolve with Hylase, but in some cases, the filler becomes encapsulated or mixed with scar tissue, which makes it harder to break down.

When lumps persist after several dissolving sessions, I usually consider the possibility of fibrosis, granuloma formation, or residual filler encapsulated in tissue. Treatment often depends on the exact cause — sometimes a small corticosteroid injection or a course of oral anti-inflammatory medication can help soften or shrink the area if inflammation or granuloma is suspected.

If the nodules are firm but non-tender, gentle radiofrequency microneedling, laser resurfacing, or ultrasound-assisted treatments may gradually smooth the surface over time. Surgical removal is rarely necessary and usually reserved for true encapsulated granulomas that don’t respond to less invasive options.

You’ve done the right thing by addressing it early and seeking professional input. With the right combination of treatments, these types of lumps can often be improved significantly without the need for surgery.

Two and a half years after dermal fillers I have lumps on my face - how can I reduce these? (Photos)

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