Lumpy temple filler results and now I have dents, should I ask for filler with a blunt canulla?

Question

It's been 10 days since I had filler I'm my temples and it's still lumpy. Plus I now have dents and grooves where I didn't before. Shall I go back and ask for filler using a blunt canulla instead. It's look like a smoother treatment?

Raffy Karamanoukian, MD, FACS · Answer

Facial fillers using Hyaluronic acid can cause immediate swelling and uneven contour. The swelling usually subsides with time. I recommend applying Plato's Bruise Balm twice daily for a few days after injecting my patients. If the filler lumps do not resolve, then a small injection of Hylenex usually can correct an HA filler that is overdone. If Hylenex does not work, combination injections with verapamil or corticosteroid IIT may help. 
In some cases, Venus Viva RF can help tighten skin thereafter. 
Best 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

It takes 1-2 weeks for final results of fillers. If you were injected with an HA filler and you're unhappy with your final results, you can have it reversed with hyaluronidase and try a different technique next time. Cannulas will limit complications. Sculptra is an alternative for the temples. See an expert. Best, Dr. Emer

Stephen P. Bracci, MD · Answer

Because you are most likely experiencing residual swelling, 10 days is premature to determine the quality of your results. Cannulas are used to improve the safety of the treatment, but do not necessarily improve the smoothness of the results. If the filler was a hyaluronic acid based filler, such as Restylane or Juvederm, then you may benefit from an injection of Hyaluronidase, an enzyme which can reduce some of the filler lumps that are the most pronounced.    
Regardless, you should wait at least 2 to 3 weeks  before determining the quality of your results. You should follow-up with the physician who administered the treatment you are referring to.

Renata Wix-Harris, MD · Answer

It usually takes 2-4 weeks for the lumps to smooth out if a HA filler was used, longer for Sculptra or Radiesse. The use of a cannula vs a needle doesn't make a difference in regards to smoothness. I would give it some time and if the irregularities remain you can consider dissolving it with hyaluronidase if a HA filler was used. Good luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question Sarah Sheldon. I understand your concern. Fillers are used to
restore lost volume in and enhance the appearance of the face. You did not state what fillers were used. However, lumps are normal for 2 weeks or so after a treatment. After that I massage the product for my patients to smoothen out lumps. I almost exclusively use needles and I have seen lumps when canullas are used. Canullas are thought to decrease the risk of bruising. Please
consult with a doctor for specific recommendations.  Good luck!

Jean M. Casello, MD · Answer

This is a good question. You do not say what filler was injected. Some of the thicker products may take longer to smooth out.  I would say wait at least 2 -4 weeks as it may take that long to see the results.   Injecting with a cannula or needle should give the same results in the hands of an experienced injector.  You should contact your provider to discuss your concerns.

Anna Avaliani, MD · Answer

Hi Sarah,  it would be helpful to know what type of filler was used for your temples.  HA fillers will even out in 2-4 weeks. But if you had Radiesse or Sculptra, it would be quite a while before those bumps go away and you might need to go back to your provider for a follow up.  Cannula technique is much more  comfortable for the patient and allows even and deeper deposition of the product. Hope this helps. Best,Dr.Avaliani

Lisa Vuich, MD · Answer

Sarah
You may still have swelling at this time, but it would be appropriate to contact your injector. Even very experienced injectors who use primarily cannula technique will still use a straight needle technique in this region, placing the filler directly at the periostium (bone surface), for the most natural looking lift. 
Best,
Lisa Vuich, MD

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